| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
1,545 |
1,077 |
$44K |
| D1120 |
Prophylaxis - child |
877 |
570 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
511 |
394 |
$14K |
| D7140 |
Extraction, erupted tooth or exposed root |
161 |
52 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
330 |
173 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
230 |
170 |
$4K |
| D0272 |
Bitewings - two radiographic images |
30 |
29 |
$596.22 |
| D0274 |
Bitewings - four radiographic images |
13 |
12 |
$198.84 |