| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1999 |
|
1,748 |
1,482 |
$30K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
397 |
223 |
$28K |
| D1120 |
Prophylaxis - child |
1,010 |
933 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
1,371 |
1,288 |
$25K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,650 |
1,534 |
$22K |
| D1110 |
Prophylaxis - adult |
577 |
542 |
$21K |
| D0330 |
Panoramic radiographic image |
501 |
461 |
$20K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
229 |
118 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
379 |
358 |
$10K |
| D0272 |
Bitewings - two radiographic images |
500 |
462 |
$8K |
| D0274 |
Bitewings - four radiographic images |
265 |
243 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
144 |
123 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
128 |
111 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
56 |
49 |
$577.50 |