| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0210 |
Intraoral - complete series of radiographic images |
2,289 |
1,737 |
$93K |
| D0140 |
Limited oral evaluation - problem focused |
2,479 |
1,907 |
$59K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
342 |
231 |
$7K |
| D1110 |
Prophylaxis - adult |
292 |
221 |
$5K |
| D0330 |
Panoramic radiographic image |
184 |
98 |
$3K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
118 |
28 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
64 |
14 |
$2K |
| D0274 |
Bitewings - four radiographic images |
59 |
51 |
$942.80 |
| D0120 |
Periodic oral evaluation - established patient |
30 |
29 |
$612.68 |
| D0220 |
Intraoral - periapical first radiographic image |
44 |
38 |
$601.78 |
| D0230 |
Intraoral - periapical each additional radiographic image |
43 |
25 |
$270.94 |