| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,281 |
2,117 |
$74K |
| 92134 |
|
4,343 |
4,225 |
$47K |
| 92250 |
|
126 |
121 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
145 |
140 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
179 |
169 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
201 |
185 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
56 |
56 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$672.66 |
| J9035 |
Injection, bevacizumab, 10 mg |
26 |
25 |
$391.38 |
| J7999 |
Compounded drug, not otherwise classified |
13 |
13 |
$0.00 |