| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
90 |
73 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
66 |
50 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
28 |
28 |
$0.00 |
| D0270 |
|
28 |
27 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
93 |
75 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
494 |
366 |
$0.00 |
| D0603 |
|
14 |
14 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
261 |
89 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
82 |
64 |
$0.00 |