| Code | Description | Claims | Beneficiaries | Total Paid |
| J0178 |
Injection, aflibercept, 1 mg |
2,607 |
1,675 |
$2.02M |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12,714 |
10,640 |
$216K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
3,843 |
2,959 |
$197K |
| 92250 |
|
5,469 |
4,495 |
$113K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,454 |
3,719 |
$101K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,686 |
3,183 |
$87K |
| 92134 |
|
6,837 |
5,624 |
$65K |
| 92235 |
|
2,395 |
2,040 |
$64K |
| 92015 |
Determination of refractive state |
1,662 |
1,463 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
858 |
798 |
$53K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,104 |
1,045 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
557 |
456 |
$28K |
| 92083 |
|
793 |
681 |
$18K |
| 92060 |
|
621 |
573 |
$18K |
| 92133 |
|
1,034 |
878 |
$15K |
| V2020 |
Frames, purchases |
512 |
488 |
$14K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
504 |
479 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
510 |
486 |
$10K |
| 92020 |
|
678 |
598 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
179 |
175 |
$5K |
| J9035 |
Injection, bevacizumab, 10 mg |
501 |
263 |
$3K |
| 92136 |
|
97 |
77 |
$2K |
| 92226 |
|
246 |
177 |
$1K |
| 92225 |
|
150 |
74 |
$973.76 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$789.75 |
| 76514 |
|
30 |
26 |
$167.42 |
| V2715 |
Prism, per lens |
26 |
25 |
$130.60 |
| 99072 |
|
45 |
41 |
$0.00 |