| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
1,826 |
1,650 |
$57K |
| D0210 |
Intraoral - complete series of radiographic images |
977 |
880 |
$52K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,129 |
964 |
$44K |
| D1110 |
Prophylaxis - adult |
796 |
724 |
$34K |
| D7140 |
Extraction, erupted tooth or exposed root |
473 |
211 |
$33K |
| D0330 |
Panoramic radiographic image |
2,195 |
1,986 |
$20K |
| D0220 |
Intraoral - periapical first radiographic image |
2,137 |
1,932 |
$18K |
| D0274 |
Bitewings - four radiographic images |
1,235 |
1,115 |
$7K |
| D0230 |
Intraoral - periapical each additional radiographic image |
484 |
364 |
$2K |
| D0272 |
Bitewings - two radiographic images |
126 |
125 |
$1K |
| D1999 |
|
2,161 |
1,850 |
$0.00 |