| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
1,282 |
889 |
$137K |
| D7140 |
Extraction, erupted tooth or exposed root |
225 |
121 |
$0.00 |
| D1330 |
|
105 |
97 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
262 |
203 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
33 |
32 |
$0.00 |
| D0603 |
|
55 |
54 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
214 |
193 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
17 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
170 |
147 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
203 |
183 |
$0.00 |
| D1110 |
Prophylaxis - adult |
119 |
102 |
$0.00 |
| D0330 |
Panoramic radiographic image |
175 |
155 |
$0.00 |