| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
40,925 |
36,896 |
$40K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,727 |
4,621 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
3,480 |
3,417 |
$4K |
| D1110 |
Prophylaxis - adult |
11,330 |
11,191 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
8,820 |
8,730 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,979 |
1,934 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
3,487 |
3,444 |
$275.38 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,907 |
2,776 |
$213.27 |
| D0140 |
Limited oral evaluation - problem focused |
24 |
24 |
$39.75 |
| D1206 |
Topical application of fluoride varnish |
9,634 |
9,605 |
$22.12 |
| D9933 |
|
480 |
476 |
$0.00 |
| D9932 |
|
1,216 |
1,196 |
$0.00 |
| D5110 |
|
65 |
64 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
69 |
26 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
18 |
17 |
$0.00 |
| D4999 |
|
2,422 |
2,201 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
871 |
269 |
$0.00 |