| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
19,654 |
9,210 |
$1.38M |
| D2332 |
|
17,055 |
7,009 |
$1.29M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
10,717 |
2,380 |
$1.24M |
| D2140 |
|
16,292 |
6,693 |
$640K |
| D1110 |
Prophylaxis - adult |
16,132 |
16,027 |
$605K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
7,181 |
4,327 |
$387K |
| D0140 |
Limited oral evaluation - problem focused |
16,185 |
15,936 |
$349K |
| D2160 |
|
4,696 |
3,415 |
$299K |
| D0220 |
Intraoral - periapical first radiographic image |
24,712 |
18,666 |
$288K |
| D2330 |
|
6,033 |
3,636 |
$282K |
| D1208 |
Topical application of fluoride, excluding varnish |
9,058 |
8,262 |
$260K |
| D0210 |
Intraoral - complete series of radiographic images |
3,785 |
3,754 |
$190K |
| D0120 |
Periodic oral evaluation - established patient |
13,091 |
12,977 |
$180K |
| D0274 |
Bitewings - four radiographic images |
6,655 |
6,623 |
$176K |
| D2331 |
|
1,850 |
1,133 |
$159K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,772 |
3,739 |
$95K |
| D2161 |
|
318 |
277 |
$23K |
| D4346 |
|
139 |
135 |
$10K |
| D1206 |
Topical application of fluoride varnish |
62 |
58 |
$2K |
| D0602 |
|
8,977 |
8,236 |
$84.21 |