| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
1,001 |
783 |
$789K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
6,549 |
5,147 |
$181K |
| 92134 |
|
12,444 |
11,139 |
$165K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,296 |
5,469 |
$158K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,127 |
1,990 |
$87K |
| 92250 |
|
2,224 |
2,081 |
$36K |
| 92226 |
|
3,454 |
1,835 |
$27K |
| 92202 |
|
2,817 |
2,579 |
$15K |
| J2778 |
Injection, ranibizumab, 0.1 mg |
22 |
13 |
$11K |
| J9035 |
Injection, bevacizumab, 10 mg |
227 |
172 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
97 |
92 |
$6K |
| 92020 |
|
319 |
289 |
$3K |
| 92225 |
|
236 |
120 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49 |
48 |
$2K |
| 92235 |
|
42 |
38 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
26 |
$1K |
| 92201 |
|
94 |
83 |
$990.44 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$976.53 |
| 99072 |
|
42 |
40 |
$0.00 |