| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
2,029 |
1,744 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
322 |
321 |
$369.66 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
338 |
334 |
$227.64 |
| D1206 |
Topical application of fluoride varnish |
498 |
477 |
$187.20 |
| D1110 |
Prophylaxis - adult |
222 |
216 |
$126.72 |
| D0274 |
Bitewings - four radiographic images |
72 |
69 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
39 |
14 |
$0.00 |
| D4910 |
|
29 |
28 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
67 |
64 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
151 |
144 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
34 |
31 |
$0.00 |