| Code | Description | Claims | Beneficiaries | Total Paid |
| 67028 |
Intravitreal injection of a pharmacologic agent |
3,836 |
3,451 |
$396K |
| J0178 |
Injection, aflibercept, 1 mg |
249 |
222 |
$284K |
| 92060 |
|
4,565 |
4,331 |
$228K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,768 |
2,466 |
$224K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,023 |
1,878 |
$218K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,627 |
2,461 |
$201K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,374 |
2,184 |
$131K |
| J9035 |
Injection, bevacizumab, 10 mg |
2,372 |
2,155 |
$129K |
| 92134 |
|
6,215 |
5,635 |
$128K |
| V2020 |
Frames, purchases |
2,434 |
1,892 |
$98K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,266 |
2,013 |
$82K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
333 |
316 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,302 |
1,868 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,188 |
561 |
$30K |
| 67311 |
|
16 |
13 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
187 |
93 |
$6K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
119 |
39 |
$5K |
| 92133 |
|
162 |
145 |
$4K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
14 |
13 |
$3K |
| 92083 |
|
107 |
96 |
$3K |
| 92015 |
Determination of refractive state |
872 |
609 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
114 |
53 |
$863.20 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$474.75 |
| 92201 |
|
28 |
12 |
$458.49 |
| 92136 |
|
14 |
14 |
$380.44 |