| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
389 |
349 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
327 |
299 |
$10K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
83 |
14 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
161 |
145 |
$4K |
| D0274 |
Bitewings - four radiographic images |
249 |
226 |
$3K |
| D9610 |
|
45 |
29 |
$1K |
| D1999 |
|
183 |
148 |
$885.00 |
| D0220 |
Intraoral - periapical first radiographic image |
63 |
56 |
$376.48 |
| D0230 |
Intraoral - periapical each additional radiographic image |
20 |
12 |
$28.59 |