| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9999 |
Unspecified adjunctive procedure, by report |
132,345 |
109,861 |
$20.87M |
| D0999 |
Unspecified diagnostic procedure, by report |
47,508 |
40,532 |
$7.53M |
| D8670 |
Periodic orthodontic treatment visit |
3,687 |
3,687 |
$1.16M |
| D7140 |
Extraction, erupted tooth or exposed root |
35,170 |
26,521 |
$1.07M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
12,992 |
9,563 |
$979K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,886 |
1,872 |
$913K |
| D0140 |
Limited oral evaluation - problem focused |
42,422 |
35,893 |
$522K |
| D7240 |
Removal of impacted tooth - completely bony |
869 |
634 |
$509K |
| D5110 |
|
4,453 |
2,297 |
$471K |
| D0120 |
Periodic oral evaluation - established patient |
48,341 |
39,944 |
$455K |
| D9222 |
|
1,903 |
1,889 |
$368K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
359 |
359 |
$346K |
| D1110 |
Prophylaxis - adult |
30,040 |
25,493 |
$296K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
19,272 |
15,469 |
$292K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
14,714 |
12,208 |
$183K |
| D9310 |
|
2,193 |
2,192 |
$183K |
| D5213 |
|
1,867 |
1,151 |
$173K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
14,043 |
11,211 |
$171K |
| D4341 |
|
5,687 |
3,081 |
$153K |
| D0330 |
Panoramic radiographic image |
24,448 |
23,676 |
$138K |
| D0340 |
|
2,428 |
2,425 |
$123K |
| D2752 |
|
1,475 |
1,151 |
$121K |
| D7230 |
|
989 |
728 |
$119K |
| D2330 |
|
3,975 |
2,993 |
$89K |
| D0470 |
|
2,654 |
2,652 |
$89K |
| D2331 |
|
3,783 |
3,111 |
$79K |
| D0220 |
Intraoral - periapical first radiographic image |
42,482 |
40,060 |
$74K |
| D8660 |
|
2,350 |
2,345 |
$70K |
| D4910 |
|
1,925 |
1,723 |
$67K |
| D0274 |
Bitewings - four radiographic images |
19,354 |
18,288 |
$52K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
2,912 |
2,676 |
$50K |
| D4342 |
|
2,605 |
1,550 |
$50K |
| D9110 |
|
12,504 |
12,028 |
$49K |
| D0350 |
|
2,696 |
2,694 |
$33K |
| D5214 |
|
867 |
618 |
$32K |
| D1120 |
Prophylaxis - child |
17,690 |
17,220 |
$29K |
| D9610 |
|
2,374 |
2,331 |
$26K |
| D2332 |
|
1,772 |
1,494 |
$20K |
| D2335 |
|
1,391 |
1,138 |
$17K |
| D5120 |
|
1,229 |
796 |
$14K |
| D0270 |
|
12,165 |
11,732 |
$13K |
| D1351 |
Sealant - per tooth |
16,066 |
5,864 |
$10K |
| D0272 |
Bitewings - two radiographic images |
18,025 |
17,793 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
3,867 |
3,796 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,029 |
7,802 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
4,683 |
4,572 |
$5K |
| D1206 |
Topical application of fluoride varnish |
23,757 |
23,715 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
5,034 |
4,771 |
$4K |
| D9940 |
|
18 |
13 |
$3K |
| D8680 |
|
13 |
13 |
$2K |
| D9997 |
|
397 |
305 |
$2K |
| D7220 |
|
30 |
26 |
$2K |
| D3320 |
|
1,247 |
1,080 |
$2K |
| D2740 |
Crown - porcelain/ceramic |
1,253 |
923 |
$1K |
| D9995 |
|
69 |
69 |
$868.76 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
2,921 |
2,080 |
$635.77 |
| D3310 |
|
709 |
616 |
$434.19 |
| D9944 |
|
743 |
652 |
$431.38 |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
1,028 |
863 |
$400.00 |
| D2394 |
|
218 |
211 |
$382.00 |
| D1354 |
|
1,490 |
649 |
$346.50 |
| D0240 |
|
2,460 |
2,395 |
$309.42 |
| D2954 |
|
234 |
224 |
$145.00 |
| D0273 |
|
186 |
185 |
$23.00 |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
524 |
488 |
$0.00 |
| D7899 |
|
39 |
38 |
$0.00 |
| D9248 |
|
109 |
91 |
$0.00 |
| D2160 |
|
167 |
158 |
$0.00 |
| D7111 |
|
14 |
13 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
975 |
829 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
447 |
447 |
$0.00 |
| D2140 |
|
972 |
788 |
$0.00 |
| D0190 |
|
121 |
121 |
$0.00 |
| D0251 |
|
12 |
12 |
$0.00 |