| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,681 |
2,626 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,429 |
1,409 |
$59K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,070 |
840 |
$48K |
| 92015 |
Determination of refractive state |
3,275 |
3,222 |
$47K |
| 92134 |
|
2,552 |
2,440 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
319 |
309 |
$7K |
| J9035 |
Injection, bevacizumab, 10 mg |
149 |
107 |
$6K |
| 92133 |
|
194 |
191 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
88 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33 |
32 |
$588.66 |
| 76514 |
|
13 |
13 |
$45.90 |
| 92083 |
|
12 |
12 |
$44.80 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
209 |
209 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
80 |
40 |
$0.00 |
| 0517F |
|
38 |
38 |
$0.00 |
| 2021F |
|
206 |
206 |
$0.00 |
| V2020 |
Frames, purchases |
297 |
293 |
$0.00 |
| 2027F |
|
65 |
65 |
$0.00 |
| 5010F |
|
208 |
208 |
$0.00 |
| 2022F |
|
213 |
213 |
$0.00 |