| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,033 |
1,655 |
$497K |
| J9035 |
Injection, bevacizumab, 10 mg |
2,453 |
2,009 |
$167K |
| 92134 |
|
3,678 |
3,324 |
$106K |
| 92226 |
|
1,502 |
884 |
$66K |
| J0178 |
Injection, aflibercept, 1 mg |
57 |
46 |
$66K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,287 |
1,186 |
$60K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
654 |
631 |
$24K |
| J2778 |
Injection, ranibizumab, 0.1 mg |
46 |
42 |
$19K |
| 92202 |
|
1,227 |
1,077 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
206 |
145 |
$15K |
| 92201 |
|
667 |
583 |
$15K |
| 92225 |
|
234 |
128 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
126 |
126 |
$7K |
| 92250 |
|
107 |
106 |
$4K |
| G8482 |
Influenza immunization administered or previously received |
1,273 |
1,059 |
$0.15 |
| 4040F |
|
1,995 |
1,638 |
$0.12 |
| 1036F |
|
1,811 |
1,502 |
$0.10 |
| 2022F |
|
1,582 |
1,262 |
$0.08 |
| 5010F |
|
1,483 |
1,169 |
$0.04 |
| 2021F |
|
1,464 |
1,150 |
$0.04 |
| 4177F |
|
31 |
29 |
$0.01 |
| G9974 |
Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity |
30 |
28 |
$0.01 |
| 99024 |
|
34 |
24 |
$0.00 |