| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
55 |
54 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
339 |
330 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,144 |
1,103 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
415 |
392 |
$24K |
| 92015 |
Determination of refractive state |
2,657 |
1,935 |
$16K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
769 |
723 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
119 |
119 |
$9K |
| 92134 |
|
1,317 |
1,257 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
332 |
320 |
$6K |
| 92250 |
|
343 |
330 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
317 |
301 |
$5K |
| J9035 |
Injection, bevacizumab, 10 mg |
138 |
130 |
$4K |
| 92060 |
|
116 |
111 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$935.24 |
| 92133 |
|
28 |
28 |
$128.76 |