| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,872 |
1,832 |
$45K |
| D1110 |
Prophylaxis - adult |
931 |
913 |
$39K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,589 |
1,551 |
$29K |
| D0272 |
Bitewings - two radiographic images |
1,380 |
1,355 |
$28K |
| D1120 |
Prophylaxis - child |
652 |
638 |
$22K |
| D0220 |
Intraoral - periapical first radiographic image |
1,281 |
1,246 |
$21K |
| D0230 |
Intraoral - periapical each additional radiographic image |
902 |
863 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
171 |
167 |
$5K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
181 |
166 |
$4K |
| D0240 |
|
141 |
71 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
28 |
26 |
$2K |
| D2140 |
|
19 |
13 |
$1K |