| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
58 |
58 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
58 |
58 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$791.98 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
16 |
$716.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$626.99 |
| 92551 |
|
27 |
27 |
$358.92 |
| 90686 |
|
20 |
20 |
$180.00 |
| 90670 |
|
17 |
17 |
$153.00 |
| 90698 |
|
12 |
12 |
$108.00 |
| 97802 |
|
27 |
27 |
$91.05 |
| G9920 |
Screening performed and negative |
28 |
28 |
$29.00 |