| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92226 |
|
743 |
359 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
400 |
324 |
$12K |
| 92134 |
|
844 |
704 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
68 |
63 |
$3K |
| 92201 |
|
118 |
92 |
$2K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
19 |
14 |
$2K |
| J7999 |
Compounded drug, not otherwise classified |
17 |
13 |
$987.95 |
| 92202 |
|
95 |
82 |
$690.06 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$631.40 |
| S9999 |
Sales tax |
34 |
24 |
$0.00 |