| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0210 |
Intraoral - complete series of radiographic images |
1,136 |
1,122 |
$26K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,535 |
1,518 |
$23K |
| D0274 |
Bitewings - four radiographic images |
556 |
532 |
$2K |
| D0277 |
|
699 |
677 |
$2K |
| D0272 |
Bitewings - two radiographic images |
537 |
513 |
$2K |
| D0273 |
|
678 |
658 |
$2K |
| D0270 |
|
683 |
656 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
34 |
32 |
$360.00 |
| D0220 |
Intraoral - periapical first radiographic image |
128 |
126 |
$307.75 |
| D0191 |
|
288 |
276 |
$285.00 |
| D0120 |
Periodic oral evaluation - established patient |
19 |
19 |
$282.00 |
| D0180 |
|
14 |
14 |
$220.00 |
| D0190 |
|
298 |
286 |
$85.00 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$10.00 |
| D0240 |
|
17 |
17 |
$5.00 |
| D9994 |
|
16 |
14 |
$0.00 |
| D0601 |
|
16 |
13 |
$0.00 |