| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
13,835 |
12,320 |
$1.56M |
| D7140 |
Extraction, erupted tooth or exposed root |
851 |
415 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
5,933 |
5,529 |
$375.00 |
| D0140 |
Limited oral evaluation - problem focused |
3,562 |
3,388 |
$313.60 |
| D0274 |
Bitewings - four radiographic images |
1,988 |
1,895 |
$308.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,513 |
3,320 |
$174.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,235 |
1,159 |
$165.00 |
| D1120 |
Prophylaxis - child |
154 |
150 |
$0.00 |
| D0330 |
Panoramic radiographic image |
1,549 |
1,532 |
$0.00 |
| D4341 |
|
314 |
186 |
$0.00 |
| D1110 |
Prophylaxis - adult |
402 |
389 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
13 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
777 |
695 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,334 |
1,322 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
71 |
55 |
$0.00 |
| D1330 |
|
598 |
593 |
$0.00 |