| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
449 |
298 |
$72K |
| 92134 |
|
2,124 |
1,868 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
326 |
307 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
475 |
410 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
149 |
141 |
$6K |
| J9035 |
Injection, bevacizumab, 10 mg |
51 |
40 |
$4K |
| 92201 |
|
44 |
42 |
$464.48 |