| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
237 |
233 |
$96K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
768 |
746 |
$32K |
| 92134 |
|
1,222 |
1,173 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
62 |
62 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
102 |
$4K |
| 92201 |
|
326 |
321 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
117 |
117 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
25 |
$1K |
| J9035 |
Injection, bevacizumab, 10 mg |
18 |
16 |
$581.27 |