| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
468 |
434 |
$70K |
| D0220 |
Intraoral - periapical first radiographic image |
87 |
84 |
$0.00 |
| D1120 |
Prophylaxis - child |
188 |
183 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
66 |
64 |
$0.00 |
| D0190 |
|
15 |
13 |
$0.00 |
| D1110 |
Prophylaxis - adult |
16 |
16 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
31 |
30 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
18 |
18 |
$0.00 |
| D0603 |
|
271 |
255 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
262 |
255 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
371 |
71 |
$0.00 |
| D0602 |
|
57 |
57 |
$0.00 |
| D1351 |
Sealant - per tooth |
56 |
13 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
55 |
50 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19 |
13 |
$0.00 |