| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
2,421 |
1,898 |
$220K |
| D0220 |
Intraoral - periapical first radiographic image |
552 |
526 |
$0.00 |
| D1120 |
Prophylaxis - child |
662 |
630 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
58 |
50 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
18 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
506 |
488 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
737 |
704 |
$0.00 |
| D0602 |
|
274 |
269 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
154 |
154 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
37 |
37 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
384 |
367 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
40 |
31 |
$0.00 |
| D0601 |
|
39 |
39 |
$0.00 |
| D0603 |
|
88 |
81 |
$0.00 |