| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
544 |
502 |
$232K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,069 |
1,959 |
$77K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,244 |
1,239 |
$41K |
| 92134 |
|
3,172 |
3,106 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
470 |
467 |
$21K |
| J9035 |
Injection, bevacizumab, 10 mg |
817 |
784 |
$16K |
| 92250 |
|
790 |
783 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
272 |
268 |
$6K |
| 92202 |
|
126 |
126 |
$466.51 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$206.21 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
16 |
$157.86 |
| 92201 |
|
12 |
12 |
$55.80 |