| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7999 |
Compounded drug, not otherwise classified |
4,210 |
3,196 |
$208K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
5,784 |
4,372 |
$169K |
| 92250 |
|
4,405 |
4,332 |
$58K |
| Q5124 |
Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg |
218 |
175 |
$43K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,813 |
5,709 |
$42K |
| 92226 |
|
3,204 |
1,917 |
$34K |
| 92134 |
|
3,530 |
3,421 |
$30K |
| J2778 |
Injection, ranibizumab, 0.1 mg |
18 |
13 |
$13K |
| 92235 |
|
961 |
953 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
893 |
874 |
$3K |
| 92225 |
|
26 |
13 |
$359.06 |
| 92201 |
|
203 |
201 |
$175.48 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$139.95 |
| 92083 |
|
13 |
13 |
$121.11 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
38 |
$71.52 |
| 92242 |
|
13 |
13 |
$53.95 |