| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
868 |
692 |
$1.50M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,626 |
2,626 |
$274K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,776 |
1,768 |
$143K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,367 |
1,047 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,427 |
1,263 |
$75K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
875 |
869 |
$63K |
| 92134 |
|
1,593 |
1,515 |
$40K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
188 |
179 |
$10K |
| 92250 |
|
367 |
364 |
$9K |
| 92083 |
|
197 |
197 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
69 |
69 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
54 |
54 |
$4K |
| 92136 |
|
197 |
164 |
$3K |
| 92133 |
|
128 |
128 |
$3K |
| 92201 |
|
12 |
12 |
$189.51 |
| 92015 |
Determination of refractive state |
14 |
14 |
$57.70 |