| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
412 |
309 |
$100K |
| 00142 |
|
326 |
239 |
$14K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,427 |
1,636 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
383 |
308 |
$5K |
| 92134 |
|
2,628 |
1,905 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
674 |
501 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
153 |
119 |
$2K |
| 92015 |
Determination of refractive state |
529 |
428 |
$1K |
| J9035 |
Injection, bevacizumab, 10 mg |
219 |
158 |
$1K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
78 |
44 |
$433.48 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
17 |
12 |
$374.75 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
50 |
$239.71 |
| 92250 |
|
216 |
188 |
$199.35 |
| 92235 |
|
55 |
43 |
$84.69 |
| 92083 |
|
15 |
12 |
$46.58 |
| 92136 |
|
36 |
25 |
$43.93 |
| 92133 |
|
15 |
13 |
$27.79 |
| 92285 |
|
45 |
40 |
$16.97 |
| J7999 |
Compounded drug, not otherwise classified |
25 |
12 |
$0.00 |