| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
10,515 |
8,418 |
$281K |
| D0120 |
Periodic oral evaluation - established patient |
9,779 |
7,787 |
$136K |
| D1999 |
|
7,780 |
6,967 |
$119K |
| D0272 |
Bitewings - two radiographic images |
7,826 |
6,362 |
$111K |
| D0330 |
Panoramic radiographic image |
3,363 |
2,818 |
$97K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,917 |
1,317 |
$78K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,704 |
2,224 |
$57K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,168 |
779 |
$45K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,195 |
2,565 |
$44K |
| D1120 |
Prophylaxis - child |
2,047 |
1,644 |
$37K |
| D2140 |
|
548 |
413 |
$18K |
| D2160 |
|
355 |
282 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
437 |
391 |
$7K |
| D2335 |
|
60 |
39 |
$5K |