| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,044 |
797 |
$275K |
| 92015 |
Determination of refractive state |
1,899 |
1,825 |
$131K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
659 |
636 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
901 |
857 |
$93K |
| 92250 |
|
1,224 |
1,178 |
$67K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
703 |
636 |
$48K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
468 |
403 |
$22K |
| 92134 |
|
570 |
500 |
$17K |
| J2778 |
Injection, ranibizumab, 0.1 mg |
14 |
12 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |
| 92133 |
|
42 |
39 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
26 |
25 |
$674.92 |
| 3072F |
|
113 |
107 |
$0.00 |