| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
24 |
24 |
$45K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
528 |
478 |
$38K |
| 92134 |
|
1,275 |
1,154 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
186 |
176 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
71 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
42 |
40 |
$3K |
| J9035 |
Injection, bevacizumab, 10 mg |
28 |
25 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$871.86 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$737.41 |
| 92250 |
|
33 |
25 |
$417.88 |