| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
314 |
300 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
139 |
135 |
$19K |
| 92134 |
|
453 |
440 |
$8K |
| 92226 |
|
732 |
419 |
$7K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
39 |
38 |
$4K |
| 92235 |
|
74 |
73 |
$3K |
| 92225 |
|
306 |
153 |
$2K |
| 92250 |
|
76 |
73 |
$2K |
| J9035 |
Injection, bevacizumab, 10 mg |
36 |
35 |
$833.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
23 |
23 |
$478.83 |
| 92015 |
Determination of refractive state |
12 |
12 |
$354.20 |