| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,283 |
4,264 |
$269K |
| D0230 |
Intraoral - periapical each additional radiographic image |
27,555 |
5,105 |
$112K |
| D0274 |
Bitewings - four radiographic images |
3,502 |
3,486 |
$74K |
| D0330 |
Panoramic radiographic image |
951 |
951 |
$28K |
| D9430 |
|
448 |
444 |
$14K |
| D0210 |
Intraoral - complete series of radiographic images |
160 |
160 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
486 |
485 |
$6K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
20 |
13 |
$2K |