| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
250 |
250 |
$8K |
| J9035 |
Injection, bevacizumab, 10 mg |
37 |
33 |
$4K |
| 92235 |
|
81 |
81 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
99 |
$2K |
| 92250 |
|
65 |
65 |
$1K |
| 92133 |
|
29 |
29 |
$609.38 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
32 |
$436.36 |
| 67028 |
Intravitreal injection of a pharmacologic agent |
37 |
33 |
$368.43 |
| 92134 |
|
210 |
210 |
$361.24 |
| 92020 |
|
29 |
29 |
$329.39 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
17 |
17 |
$307.44 |
| 76514 |
|
29 |
29 |
$171.94 |