| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$296.16 |
| 92551 |
|
24 |
24 |
$171.70 |
| 97802 |
|
61 |
61 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
61 |
61 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
62 |
62 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
33 |
$0.00 |
| 99172 |
|
15 |
15 |
$0.00 |
| 90657 |
|
14 |
14 |
$0.00 |
| 99401 |
|
61 |
61 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
61 |
61 |
$0.00 |