| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
587 |
520 |
$37K |
| 92134 |
|
1,087 |
989 |
$29K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
138 |
111 |
$18K |
| 92002 |
|
237 |
220 |
$14K |
| 92202 |
|
1,068 |
991 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
49 |
$5K |
| 92015 |
Determination of refractive state |
91 |
77 |
$2K |
| J9035 |
Injection, bevacizumab, 10 mg |
21 |
15 |
$1K |
| C9257 |
Injection, bevacizumab, 0.25 mg |
44 |
29 |
$973.00 |
| 92201 |
|
48 |
28 |
$189.20 |
| 99024 |
|
15 |
12 |
$0.00 |