| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
419 |
349 |
$173K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
884 |
710 |
$62K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,622 |
2,378 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,668 |
520 |
$45K |
| V2020 |
Frames, purchases |
1,140 |
780 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
499 |
472 |
$20K |
| 92250 |
|
1,035 |
951 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,435 |
1,224 |
$10K |
| 92235 |
|
1,090 |
1,003 |
$9K |
| 92134 |
|
601 |
587 |
$9K |
| J9035 |
Injection, bevacizumab, 10 mg |
107 |
92 |
$5K |
| 92133 |
|
168 |
165 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,278 |
372 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$1K |
| 92020 |
|
132 |
130 |
$1K |
| 92083 |
|
30 |
29 |
$857.44 |
| 92202 |
|
32 |
24 |
$199.47 |
| 92226 |
|
114 |
57 |
$28.91 |
| 92015 |
Determination of refractive state |
28 |
27 |
$4.50 |