| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
28 |
28 |
$11K |
| 92134 |
|
1,417 |
1,328 |
$10K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
366 |
347 |
$10K |
| 92250 |
|
614 |
599 |
$7K |
| 92235 |
|
223 |
222 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
152 |
150 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
94 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
269 |
253 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
162 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
60 |
54 |
$2K |
| J9035 |
Injection, bevacizumab, 10 mg |
104 |
96 |
$2K |
| 92273 |
|
48 |
48 |
$999.23 |
| 92287 |
|
63 |
63 |
$830.30 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
27 |
$300.37 |
| 92020 |
|
15 |
15 |
$135.41 |
| 92202 |
|
16 |
16 |
$52.87 |
| 5010F |
|
157 |
132 |
$0.00 |
| 2024F |
|
121 |
101 |
$0.00 |
| 1100F |
|
198 |
173 |
$0.00 |
| 2022F |
|
121 |
101 |
$0.00 |
| 2026F |
|
121 |
101 |
$0.00 |