| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
16,640 |
16,091 |
$3.71M |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
1,360 |
1,316 |
$1.16M |
| D8999 |
|
4,121 |
4,012 |
$169K |
| D8680 |
|
839 |
804 |
$117K |
| D8660 |
|
421 |
403 |
$37K |
| D0140 |
Limited oral evaluation - problem focused |
611 |
577 |
$10K |
| D9110 |
|
175 |
156 |
$9K |
| D0330 |
Panoramic radiographic image |
313 |
310 |
$7K |
| D9310 |
|
210 |
210 |
$3K |
| D1110 |
Prophylaxis - adult |
36 |
35 |
$1K |
| D1120 |
Prophylaxis - child |
24 |
24 |
$598.60 |
| D0120 |
Periodic oral evaluation - established patient |
29 |
29 |
$392.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$327.60 |
| D0220 |
Intraoral - periapical first radiographic image |
66 |
65 |
$296.16 |
| D0230 |
Intraoral - periapical each additional radiographic image |
65 |
64 |
$253.96 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$169.00 |
| D1999 |
|
13 |
12 |
$0.00 |