| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
83,772 |
83,463 |
$4.26M |
| D1120 |
Prophylaxis - child |
97,732 |
97,348 |
$3.82M |
| D1310 |
|
46,228 |
46,062 |
$2.11M |
| D0230 |
Intraoral - periapical each additional radiographic image |
484,520 |
95,618 |
$1.96M |
| D9993 |
|
24,310 |
24,302 |
$1.54M |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
33,572 |
33,010 |
$1.32M |
| D1206 |
Topical application of fluoride varnish |
71,273 |
70,908 |
$1.21M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
18,396 |
18,351 |
$1.17M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
18,166 |
13,579 |
$1.17M |
| D1351 |
Sealant - per tooth |
29,770 |
8,066 |
$911K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
6,683 |
5,538 |
$771K |
| D7140 |
Extraction, erupted tooth or exposed root |
12,653 |
9,407 |
$697K |
| D0272 |
Bitewings - two radiographic images |
54,317 |
54,102 |
$633K |
| D0603 |
|
40,584 |
40,437 |
$602K |
| D0220 |
Intraoral - periapical first radiographic image |
52,794 |
52,094 |
$594K |
| D0145 |
Oral evaluation for a patient under three years of age |
9,935 |
9,911 |
$591K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
9,244 |
7,552 |
$485K |
| D1208 |
Topical application of fluoride, excluding varnish |
33,667 |
33,646 |
$391K |
| D0350 |
|
15,666 |
11,879 |
$149K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
1,077 |
910 |
$105K |
| D9430 |
|
2,566 |
2,550 |
$80K |
| D0601 |
|
5,263 |
5,250 |
$79K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
502 |
479 |
$39K |
| D1354 |
|
3,299 |
1,012 |
$35K |
| D1510 |
|
234 |
232 |
$30K |
| D2330 |
|
160 |
117 |
$12K |
| D0274 |
Bitewings - four radiographic images |
301 |
300 |
$6K |
| D2940 |
|
32 |
27 |
$2K |
| D1556 |
|
32 |
28 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
21 |
14 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
34 |
34 |
$912.00 |
| D0270 |
|
135 |
135 |
$648.75 |
| D1999 |
|
2,068 |
2,028 |
$92.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
2,051 |
2,012 |
$6.00 |