| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,270 |
1,133 |
$63K |
| 92134 |
|
2,359 |
2,081 |
$42K |
| J9035 |
Injection, bevacizumab, 10 mg |
320 |
282 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
234 |
214 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
62 |
$5K |
| 92015 |
Determination of refractive state |
335 |
312 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
111 |
106 |
$3K |
| 92226 |
|
135 |
72 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$1K |
| 92202 |
|
154 |
145 |
$1K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$597.52 |
| J7999 |
Compounded drug, not otherwise classified |
13 |
12 |
$0.01 |