| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
407 |
405 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
423 |
415 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
367 |
357 |
$6K |
| J9035 |
Injection, bevacizumab, 10 mg |
49 |
43 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
90 |
$2K |
| 92083 |
|
42 |
42 |
$823.77 |
| 92133 |
|
39 |
39 |
$785.38 |
| 92134 |
|
228 |
226 |
$757.15 |
| V2020 |
Frames, purchases |
64 |
64 |
$748.02 |
| 92015 |
Determination of refractive state |
78 |
78 |
$296.41 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
26 |
24 |
$81.32 |
| 2023F |
|
14 |
14 |
$0.00 |
| 2022F |
|
278 |
276 |
$0.00 |
| 67028 |
Intravitreal injection of a pharmacologic agent |
45 |
43 |
$0.00 |