| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
5,268 |
4,432 |
$406K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,628 |
3,964 |
$270K |
| 92134 |
|
12,610 |
10,572 |
$200K |
| J0178 |
Injection, aflibercept, 1 mg |
166 |
146 |
$104K |
| 92250 |
|
1,085 |
974 |
$36K |
| J9035 |
Injection, bevacizumab, 10 mg |
380 |
312 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
24 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
94 |
85 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
29 |
24 |
$2K |
| 92226 |
|
170 |
90 |
$2K |
| 92235 |
|
13 |
13 |
$952.96 |
| 2024F |
|
198 |
191 |
$0.00 |
| 2022F |
|
183 |
176 |
$0.00 |
| 2026F |
|
197 |
190 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$0.00 |