| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
4,171 |
3,342 |
$625K |
| J9035 |
Injection, bevacizumab, 10 mg |
2,333 |
2,147 |
$144K |
| 92134 |
|
4,101 |
3,970 |
$109K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,475 |
3,360 |
$85K |
| 67210 |
|
152 |
132 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,669 |
1,634 |
$33K |
| 68761 |
|
334 |
303 |
$18K |
| 92235 |
|
288 |
174 |
$16K |
| 92083 |
|
829 |
824 |
$15K |
| 92133 |
|
1,063 |
1,060 |
$14K |
| J7999 |
Compounded drug, not otherwise classified |
642 |
624 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
326 |
321 |
$10K |
| 92250 |
|
363 |
359 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
144 |
143 |
$5K |
| 92136 |
|
80 |
80 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
55 |
55 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$2K |
| 76512 |
|
55 |
49 |
$903.41 |
| 92002 |
|
40 |
40 |
$0.00 |
| 92015 |
Determination of refractive state |
54 |
54 |
$0.00 |