| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
34,421 |
32,054 |
$6.88M |
| D0272 |
Bitewings - two radiographic images |
3,985 |
3,916 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
10,076 |
9,838 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,561 |
3,477 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
585 |
566 |
$0.00 |
| D1351 |
Sealant - per tooth |
1,513 |
465 |
$0.00 |
| D1330 |
|
8,816 |
8,646 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
8,868 |
8,683 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,582 |
2,031 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,758 |
735 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,185 |
1,158 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
162 |
160 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
3,338 |
3,256 |
$0.00 |
| D0240 |
|
22 |
21 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
113 |
99 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,665 |
1,641 |
$0.00 |
| D1120 |
Prophylaxis - child |
9,801 |
9,604 |
$0.00 |
| D0330 |
Panoramic radiographic image |
1,352 |
1,316 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
3,505 |
3,426 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,236 |
1,187 |
$0.00 |
| D1110 |
Prophylaxis - adult |
3,596 |
3,517 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,159 |
1,595 |
$0.00 |
| D4341 |
|
216 |
155 |
$0.00 |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
12 |
12 |
$0.00 |
| D2332 |
|
13 |
13 |
$0.00 |