| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
257 |
219 |
$131K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
1,801 |
1,471 |
$17K |
| J9035 |
Injection, bevacizumab, 10 mg |
418 |
337 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
481 |
420 |
$10K |
| 92134 |
|
2,537 |
2,184 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
253 |
231 |
$5K |
| 92015 |
Determination of refractive state |
274 |
264 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
51 |
47 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
31 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$733.97 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$426.64 |
| 92235 |
|
18 |
14 |
$204.16 |
| 92250 |
|
20 |
16 |
$135.56 |
| 92136 |
|
12 |
12 |
$54.97 |
| 99072 |
|
2,935 |
2,412 |
$6.57 |