| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
1,456 |
1,271 |
$2.38M |
| 67028 |
Intravitreal injection of a pharmacologic agent |
4,014 |
3,625 |
$404K |
| 92134 |
|
12,855 |
11,503 |
$404K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
444 |
444 |
$46K |
| 92250 |
|
1,019 |
980 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
72 |
72 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
80 |
78 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
61 |
$5K |
| J9035 |
Injection, bevacizumab, 10 mg |
31 |
26 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |