| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
194 |
152 |
$31K |
| 92250 |
|
826 |
744 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
681 |
599 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
395 |
359 |
$18K |
| 92285 |
|
980 |
887 |
$16K |
| J9035 |
Injection, bevacizumab, 10 mg |
205 |
143 |
$11K |
| 92134 |
|
197 |
159 |
$3K |
| 92083 |
|
78 |
72 |
$2K |
| 92015 |
Determination of refractive state |
58 |
56 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
84 |
78 |
$987.70 |
| 92133 |
|
53 |
51 |
$655.97 |
| 76514 |
|
144 |
130 |
$637.62 |
| G9744 |
Patient not eligible due to active diagnosis of hypertension |
378 |
315 |
$0.00 |
| 2022F |
|
181 |
166 |
$0.00 |
| 2024F |
|
108 |
96 |
$0.00 |
| 5010F |
|
20 |
14 |
$0.00 |
| 2026F |
|
108 |
96 |
$0.00 |
| G8785 |
Blood pressure reading not documented, reason not given |
333 |
296 |
$0.00 |
| 2027F |
|
52 |
50 |
$0.00 |
| 0517F |
|
52 |
50 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
720 |
621 |
$0.00 |
| G8756 |
No documentation of blood pressure measurement, reason not given |
379 |
316 |
$0.00 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
81 |
52 |
$0.00 |
| 1036F |
|
441 |
411 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
100 |
97 |
$0.00 |