| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 70486 |
|
875 |
854 |
$111K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,436 |
496 |
$80K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
711 |
690 |
$37K |
| D0330 |
Panoramic radiographic image |
134 |
133 |
$5K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
27 |
12 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
92 |
91 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
28 |
28 |
$540.60 |