Periodic Exam
D0120
Limited Exam
D0140
Comprehensive Exam
D0150
Full Mouth X-rays
D0210
Periapical Film
D0220
Additional Periapical Film
D0230
1 BWX x-ray
D0270
2 BWX x-rays
D0272
4 BWX x-rays
D0274
Panoramic Film
D0330
Intra Oral Pictures
D0350
Cone Beam CT Scan
D0367
Adult Prophy
D1110
Child Prophy
D1120
Fluoride Varnish
D1206
Fluoride w/o Varnish
D1208
Oral Hygiene Instructions
D1330
Sealant
D1351
Resin-Based Composite - 1 surface, anterior
D2330
Resin-Based Composite - 2 surfaces, anterior
D2331
Resin-Based Composite - 3 surfaces, anterior
D2332
Resin-Based Composite - 4+ surfaces, anterior
D2335
Resin-Based Composite - 1 surface, posterior
D2391
Resin-Based Composite - 2 surfaces, posterior
D2392