| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
404 |
401 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
324 |
311 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
458 |
271 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
847 |
803 |
$4K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
46 |
43 |
$3K |
| D0330 |
Panoramic radiographic image |
554 |
537 |
$2K |
| D9310 |
|
121 |
95 |
$2K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
13 |
13 |
$384.15 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$272.35 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
31 |
27 |
$129.72 |