| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
213 |
149 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
159 |
123 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
152 |
102 |
$9K |
| 92060 |
|
222 |
165 |
$8K |
| V2020 |
Frames, purchases |
247 |
165 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
150 |
109 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
86 |
$5K |
| 92134 |
|
333 |
231 |
$5K |
| J9035 |
Injection, bevacizumab, 10 mg |
85 |
66 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
257 |
172 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
522 |
173 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
131 |
55 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
35 |
12 |
$450.30 |