| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
27,127 |
26,798 |
$9.28M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
89,362 |
50,300 |
$6.27M |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
93,835 |
49,583 |
$5.61M |
| D1120 |
Prophylaxis - child |
202,161 |
199,058 |
$5.44M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
45,086 |
14,292 |
$5.02M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
50,173 |
20,135 |
$5.01M |
| D7240 |
Removal of impacted tooth - completely bony |
18,391 |
6,519 |
$3.88M |
| D1110 |
Prophylaxis - adult |
100,778 |
99,184 |
$3.65M |
| D1206 |
Topical application of fluoride varnish |
191,728 |
188,483 |
$3.25M |
| D0120 |
Periodic oral evaluation - established patient |
196,910 |
193,800 |
$3.08M |
| D1351 |
Sealant - per tooth |
119,330 |
38,896 |
$3.03M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
115,400 |
113,572 |
$2.92M |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
4,283 |
3,892 |
$2.46M |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
2,647 |
2,616 |
$2.41M |
| D7140 |
Extraction, erupted tooth or exposed root |
40,214 |
18,947 |
$2.33M |
| D8660 |
|
12,181 |
12,016 |
$2.11M |
| D0274 |
Bitewings - four radiographic images |
75,791 |
74,592 |
$1.59M |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
16,005 |
8,950 |
$1.55M |
| D0210 |
Intraoral - complete series of radiographic images |
51,737 |
50,064 |
$1.53M |
| D1208 |
Topical application of fluoride, excluding varnish |
96,642 |
95,368 |
$1.52M |
| D0272 |
Bitewings - two radiographic images |
87,820 |
86,438 |
$1.43M |
| D0220 |
Intraoral - periapical first radiographic image |
155,168 |
150,230 |
$1.39M |
| D0140 |
Limited oral evaluation - problem focused |
70,326 |
67,594 |
$1.27M |
| D2934 |
|
8,079 |
3,183 |
$1.16M |
| D0330 |
Panoramic radiographic image |
27,324 |
26,384 |
$1.12M |
| D0230 |
Intraoral - periapical each additional radiographic image |
110,291 |
96,824 |
$1.01M |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
12,635 |
5,193 |
$835K |
| D7230 |
|
4,406 |
2,558 |
$835K |
| D2950 |
|
8,156 |
6,449 |
$714K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
27,640 |
26,340 |
$697K |
| D3320 |
|
1,793 |
1,553 |
$605K |
| D7250 |
|
5,271 |
2,097 |
$528K |
| D3310 |
|
808 |
532 |
$233K |
| D2394 |
|
1,746 |
682 |
$224K |
| D2330 |
|
3,378 |
2,072 |
$210K |
| D2740 |
Crown - porcelain/ceramic |
629 |
478 |
$192K |
| D8680 |
|
385 |
384 |
$126K |
| D5110 |
|
134 |
133 |
$93K |
| D2332 |
|
864 |
451 |
$82K |
| D3120 |
|
4,846 |
3,343 |
$57K |
| D7111 |
|
3,347 |
2,196 |
$54K |
| D5120 |
|
52 |
52 |
$37K |
| D0270 |
|
4,398 |
4,323 |
$36K |
| D7310 |
|
359 |
199 |
$36K |
| D7220 |
|
184 |
110 |
$32K |
| D2335 |
|
332 |
199 |
$29K |
| D2331 |
|
251 |
141 |
$21K |
| D0170 |
|
276 |
274 |
$7K |
| D4346 |
|
111 |
107 |
$6K |
| D4355 |
|
26 |
26 |
$3K |
| D9222 |
|
21 |
21 |
$1K |
| D3221 |
|
43 |
42 |
$944.86 |
| D1999 |
|
1,068 |
967 |
$0.00 |
| D8703 |
|
13 |
13 |
$0.00 |
| D8704 |
|
15 |
15 |
$0.00 |
| D0240 |
|
24 |
12 |
$0.00 |