| Code | Description | Total Paid |
|---|---|---|
| D5110 | $274K | |
| D5120 | $101K | |
| D0140 | Limited oral evaluation - problem focused | $69K |
| D9999 | Unspecified adjunctive procedure, by report | $0.00 |
| # | Provider | Location | Claims | Total Paid |
|---|---|---|---|---|
| 1 | SHEELER, SINDIE | SEQUIM, WA | 3,685 | $444K |
| 2 | BROWN, DANTE | VALPARAISO, IN | 43 | $0.00 |