| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
26,509 |
22,691 |
$2.50M |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
1,042 |
833 |
$808K |
| D0140 |
Limited oral evaluation - problem focused |
3,451 |
3,018 |
$119K |
| D0340 |
|
2,655 |
2,191 |
$118K |
| D0330 |
Panoramic radiographic image |
2,305 |
1,809 |
$83K |
| D9310 |
|
2,088 |
1,848 |
$81K |
| D0350 |
|
2,474 |
2,039 |
$53K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
918 |
622 |
$14K |
| D8060 |
|
13 |
13 |
$14K |
| D0470 |
|
105 |
102 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
112 |
78 |
$2K |
| D1120 |
Prophylaxis - child |
63 |
38 |
$1K |
| D1206 |
Topical application of fluoride varnish |
63 |
38 |
$904.40 |
| D9110 |
|
97 |
76 |
$395.29 |
| D0230 |
Intraoral - periapical each additional radiographic image |
99 |
12 |
$317.52 |
| D0272 |
Bitewings - two radiographic images |
23 |
15 |
$203.00 |
| D0220 |
Intraoral - periapical first radiographic image |
24 |
15 |
$163.80 |