| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
3,910 |
2,917 |
$3.39M |
| J2777 |
Injection, faricimab-svoa, 0.1 mg |
1,127 |
876 |
$1.58M |
| 67028 |
Intravitreal injection of a pharmacologic agent |
19,226 |
14,625 |
$1.55M |
| J2778 |
Injection, ranibizumab, 0.1 mg |
713 |
564 |
$613K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,193 |
8,142 |
$460K |
| 92134 |
|
27,427 |
21,141 |
$423K |
| 92235 |
|
6,469 |
5,178 |
$276K |
| J9035 |
Injection, bevacizumab, 10 mg |
4,391 |
3,294 |
$217K |
| 92250 |
|
5,708 |
4,881 |
$190K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,720 |
3,672 |
$145K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,099 |
895 |
$91K |
| J0177 |
Injection, aflibercept hd, 1 mg |
26 |
25 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
300 |
257 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
196 |
131 |
$8K |
| 92225 |
|
99 |
42 |
$924.44 |
| J7999 |
Compounded drug, not otherwise classified |
58 |
50 |
$748.25 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24 |
15 |
$344.31 |
| 92226 |
|
108 |
31 |
$279.15 |
| 99072 |
|
265 |
254 |
$52.50 |