| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
70,718 |
67,216 |
$1.94M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
21,530 |
21,478 |
$1.34M |
| D0120 |
Periodic oral evaluation - established patient |
17,938 |
17,917 |
$1.22M |
| D0230 |
Intraoral - periapical each additional radiographic image |
260,095 |
30,263 |
$1.06M |
| D4355 |
|
9,057 |
9,022 |
$917K |
| D5110 |
|
751 |
751 |
$471K |
| D1110 |
Prophylaxis - adult |
5,165 |
5,154 |
$461K |
| D4341 |
|
4,737 |
1,555 |
$455K |
| D5120 |
|
654 |
654 |
$410K |
| D0220 |
Intraoral - periapical first radiographic image |
29,814 |
29,700 |
$353K |
| D4910 |
|
4,004 |
3,984 |
$312K |
| D9920 |
|
5,743 |
5,704 |
$280K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,946 |
483 |
$229K |
| D1206 |
Topical application of fluoride varnish |
9,210 |
9,163 |
$155K |
| D4342 |
|
1,741 |
841 |
$119K |
| D5750 |
|
93 |
93 |
$18K |
| D7140 |
Extraction, erupted tooth or exposed root |
218 |
66 |
$12K |
| D1208 |
Topical application of fluoride, excluding varnish |
668 |
668 |
$10K |
| D1320 |
|
441 |
440 |
$7K |
| D5850 |
|
86 |
86 |
$6K |
| D5851 |
|
73 |
73 |
$5K |
| D5751 |
|
26 |
26 |
$5K |
| D5730 |
|
36 |
36 |
$4K |
| D1330 |
|
29 |
29 |
$0.00 |