| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0272 |
Bitewings - two radiographic images |
131 |
114 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
84 |
61 |
$2K |
| D1120 |
Prophylaxis - child |
71 |
58 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
143 |
118 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
53 |
49 |
$1K |
| D1110 |
Prophylaxis - adult |
31 |
25 |
$1K |
| D0330 |
Panoramic radiographic image |
25 |
20 |
$671.53 |
| D0220 |
Intraoral - periapical first radiographic image |
57 |
51 |
$476.22 |
| D0230 |
Intraoral - periapical each additional radiographic image |
37 |
33 |
$276.24 |
| D0603 |
|
79 |
70 |
$0.01 |
| D0601 |
|
43 |
32 |
$0.00 |