| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
1,289 |
1,060 |
$0.00 |
| D1320 |
|
4,569 |
3,315 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
632 |
578 |
$0.00 |
| D0601 |
|
848 |
740 |
$0.00 |
| D1330 |
|
4,591 |
3,334 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
1,082 |
1,026 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
545 |
475 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
70 |
65 |
$0.00 |
| D0602 |
|
165 |
138 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
731 |
614 |
$0.00 |
| D1110 |
Prophylaxis - adult |
956 |
836 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
480 |
386 |
$0.00 |
| D0330 |
Panoramic radiographic image |
135 |
126 |
$0.00 |
| D1354 |
|
77 |
66 |
$0.00 |
| D0180 |
|
36 |
32 |
$0.00 |
| D0191 |
|
27 |
27 |
$0.00 |
| D1120 |
Prophylaxis - child |
15 |
15 |
$0.00 |