| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,033 |
1,005 |
$36K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
624 |
533 |
$19K |
| 92134 |
|
1,410 |
1,376 |
$18K |
| J9035 |
Injection, bevacizumab, 10 mg |
115 |
94 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
114 |
113 |
$5K |
| 92015 |
Determination of refractive state |
272 |
268 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
68 |
68 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
28 |
$894.68 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$890.41 |
| 92133 |
|
12 |
12 |
$286.23 |