| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
9,231 |
8,733 |
$241K |
| D1999 |
|
12,454 |
11,017 |
$182K |
| D0120 |
Periodic oral evaluation - established patient |
10,781 |
10,182 |
$144K |
| D0230 |
Intraoral - periapical each additional radiographic image |
15,669 |
8,028 |
$112K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
2,325 |
1,854 |
$92K |
| D0272 |
Bitewings - two radiographic images |
5,942 |
5,620 |
$84K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,893 |
1,396 |
$81K |
| D1208 |
Topical application of fluoride, excluding varnish |
4,856 |
4,572 |
$68K |
| D2140 |
|
1,847 |
1,417 |
$57K |
| D1120 |
Prophylaxis - child |
2,945 |
2,764 |
$53K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,401 |
1,310 |
$30K |
| D0140 |
Limited oral evaluation - problem focused |
1,503 |
1,424 |
$25K |
| D2160 |
|
360 |
324 |
$18K |
| D2335 |
|
223 |
144 |
$15K |
| D0210 |
Intraoral - complete series of radiographic images |
279 |
279 |
$14K |
| D0330 |
Panoramic radiographic image |
259 |
259 |
$9K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
56 |
51 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
483 |
444 |
$3K |
| D2332 |
|
39 |
27 |
$2K |
| D2940 |
|
46 |
40 |
$852.50 |