| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0601 |
|
5,023 |
4,905 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,602 |
3,567 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
2,400 |
2,383 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
897 |
877 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,829 |
1,158 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
66 |
66 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
26 |
26 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,563 |
2,445 |
$0.00 |
| D0330 |
Panoramic radiographic image |
742 |
726 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,079 |
1,055 |
$0.00 |
| D1110 |
Prophylaxis - adult |
179 |
179 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
21 |
14 |
$0.00 |