| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
712 |
688 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
127 |
125 |
$8K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
206 |
157 |
$5K |
| J9035 |
Injection, bevacizumab, 10 mg |
119 |
94 |
$4K |
| 92015 |
Determination of refractive state |
329 |
297 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
128 |
123 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
26 |
25 |
$932.76 |
| J7999 |
Compounded drug, not otherwise classified |
19 |
14 |
$544.39 |