Excel Chapter 10 Project 10-3

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2019 Dental Services ID Insurance Service Code Date Maximum Benefit Billed OP0001 CompDent D0120 1/5/19 $125.00 $135.00 OP0002 SIP D1110 1/18/19 $185.00 $135.00 OP0003 CompDent D2751 1/31/19 $235.00 $250.00 OP0004 Westville D2751 2/13/19 $135.00 $100.00 OP0005 CompDent D1110 2/26/19 $245.00 $185.00 OP0006 SIP D1110 3/11/19 $275.00 $100.00 OP0007 SIP D1110 3/24/19 $325.00 $425.00 OP0008 Westville D0120 4/6/19 $175.00 $125.00 OP0009 BlueDent D0120 4/19/19 $195.00 $145.00 OP0010 BlueDent D1110 5/2/19 $200.00 $225.00 OP0011 BlueDent D1110 5/15/19 $225.00 $235.00 OP0012 SIP D1110 5/28/19 $200.00 $185.00 OP0013 CompDent D2751 6/10/19 $475.00 $325.00 OP0014 SIP D1110 6/23/19 $235.00 $235.00 OP0015 SIP D1110 7/6/19 $235.00 $245.00 OP0016 BlueDent D1110 1/31/19 $225.00 $200.00 OP0017 BlueDent D0120 2/13/19 $185.00 $175.00 OP0018 Westville D0120 7/19/19 $195.00 $150.00 OP0019 Westville D1110 8/1/19 $225.00 $125.00 OP0020 CompDent D2751 8/14/19 $375.00 $500.00 OP0021 CompDent D2330 8/27/19 $325.00 $400.00 OP0022 Westville D2751 9/9/19 $450.00 $400.00 OP0023 Westville D0120 9/22/19 $325.00 $300.00 OP0024 SIP D0210 10/5/19 $500.00 $550.00 OP0025 SIP D0120 10/18/19 $250.00 $250.00 OP0026 BlueDent D2751 10/31/19 $125.00 $115.00 OP0027 CompDent D0120 11/13/19 $325.00 $300.00 OP0028 Westville D2330 11/26/19 $275.00 $250.00 OP0029 SIP D2751 12/9/19 $200.00 $235.00 OP0030 BlueDent D1110 12/22/19 $185.00 $175.00 OP0031 CompDent D2330 2/26/19 $225.00 $235.00 2020 Dental Services ID Insurance Service Code Date Maximum Benefit Billed OP0032 BlueDent D1110 2/2/20 $225.00 $200.00 OP0033 BlueDent D0120 2/14/20 $185.00 $175.00 OP0034 Westville D0120 2/26/20 $195.00 $150.00 OP0035 Westville D1110 3/9/20 $225.00 $125.00 OP0036 CompDent D2751 3/21/20 $375.00 $500.00 OP0037 CompDent D2330 4/2/20 $325.00 $400.00 OP0038 Westville D2751 4/14/20 $450.00 $400.00 OP0039 Westville D0120 4/26/20 $325.00 $300.00 OP0040 SIP D0210 5/8/20 $500.00 $550.00 OP0041 SIP D0120 5/20/20 $250.00 $250.00 OP0042 BlueDent D2751 6/1/20 $125.00 $115.00 OP0043 CompDent D2751 6/13/20 $475.00 $325.00 OP0044 SIP D1110 6/25/20 $235.00 $235.00 OP0045 SIP D1110 7/7/20 $235.00 $245.00 OP0046 BlueDent D1110 7/19/20 $225.00 $200.00 OP0047 BlueDent D0120 7/31/20 $185.00 $175.00 OP0048 Westville D0120 8/12/20 $195.00 $150.00 OP0049 CompDent D0120 8/24/20 $125.00 $135.00 OP0050 SIP D1110 9/5/20 $185.00 $135.00 OP0051 CompDent D2751 9/17/20 $235.00 $250.00 OP0052 Westville D2751 9/29/20 $135.00 $100.00 OP0053 CompDent D1110 10/11/20 $245.00 $185.00 OP0054 SIP D1110 10/23/20 $275.00 $100.00 OP0055 SIP D1110 11/4/20 $325.00 $425.00 OP0056 Westville D0120 11/16/20 $175.00 $125.00 OP0057 BlueDent D0120 11/28/20 $195.00 $145.00 OP0058 BlueDent D1110 12/10/20 $200.00 $225.00 OP0059 BlueDent D1110 12/22/20 $225.00 $235.00 OP0060 Westville D120 12/23/20 $250.00 $325.00

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