| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
6,260 |
4,573 |
$544K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,246 |
721 |
$0.00 |
| D2330 |
|
14 |
12 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
40 |
40 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
707 |
660 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
664 |
561 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,060 |
903 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
989 |
801 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
172 |
137 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
313 |
297 |
$0.00 |
| D2160 |
|
67 |
58 |
$0.00 |
| D1351 |
Sealant - per tooth |
63 |
25 |
$0.00 |
| D2331 |
|
31 |
25 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,047 |
892 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
460 |
360 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
647 |
596 |
$0.00 |
| D2140 |
|
300 |
265 |
$0.00 |
| D1110 |
Prophylaxis - adult |
322 |
267 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
411 |
310 |
$0.00 |
| D0330 |
Panoramic radiographic image |
142 |
135 |
$0.00 |