| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
50 |
50 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
47 |
$1K |
| 92551 |
|
227 |
226 |
$888.80 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$542.80 |
| 92081 |
|
105 |
105 |
$5.04 |
| 99401 |
|
181 |
179 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
181 |
179 |
$0.00 |
| 99172 |
|
138 |
136 |
$0.00 |
| 97802 |
|
181 |
179 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
181 |
179 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
37 |
$0.00 |