| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
138 |
127 |
$264K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,266 |
1,131 |
$106K |
| J3590 |
Unclassified biologics |
826 |
770 |
$69K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,424 |
1,326 |
$50K |
| 92015 |
Determination of refractive state |
2,909 |
2,784 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
797 |
766 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
940 |
913 |
$37K |
| 67228 |
|
53 |
40 |
$26K |
| 92250 |
|
942 |
899 |
$24K |
| 92134 |
|
1,436 |
1,358 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
346 |
340 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
191 |
180 |
$14K |
| 92235 |
|
312 |
296 |
$11K |
| 92133 |
|
275 |
267 |
$3K |
| V2020 |
Frames, purchases |
125 |
125 |
$2K |
| 92083 |
|
78 |
78 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
104 |
104 |
$832.00 |
| 76514 |
|
12 |
12 |
$68.70 |