| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
851 |
708 |
$91K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
544 |
536 |
$80K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,831 |
793 |
$72K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
340 |
328 |
$36K |
| 70355 |
|
1,504 |
1,416 |
$28K |
| 99205 |
Prolong outpt/office vis |
141 |
138 |
$25K |
| D0140 |
Limited oral evaluation - problem focused |
484 |
480 |
$14K |
| D0330 |
Panoramic radiographic image |
291 |
289 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
292 |
291 |
$9K |