| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
1,797 |
1,537 |
$2.74M |
| 67028 |
Intravitreal injection of a pharmacologic agent |
6,444 |
5,668 |
$709K |
| 92134 |
|
16,985 |
16,392 |
$526K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,948 |
2,895 |
$204K |
| 92201 |
|
4,563 |
4,515 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
939 |
922 |
$66K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
217 |
217 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
284 |
281 |
$25K |
| 92250 |
|
577 |
563 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
82 |
82 |
$12K |
| J9035 |
Injection, bevacizumab, 10 mg |
140 |
120 |
$9K |
| 92226 |
|
223 |
160 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$2K |
| 92235 |
|
24 |
24 |
$2K |
| 92202 |
|
51 |
51 |
$620.88 |
| 92225 |
|
18 |
12 |
$289.20 |
| 99072 |
|
25 |
25 |
$115.00 |
| 2021F |
|
80 |
77 |
$0.00 |
| 5010F |
|
80 |
77 |
$0.00 |