| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
1,327 |
841 |
$825K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,846 |
3,434 |
$229K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,750 |
1,696 |
$188K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
5,019 |
3,231 |
$160K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,435 |
2,257 |
$135K |
| 92134 |
|
7,661 |
5,356 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,600 |
1,301 |
$75K |
| J9035 |
Injection, bevacizumab, 10 mg |
1,302 |
1,011 |
$63K |
| 92015 |
Determination of refractive state |
4,630 |
4,466 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,607 |
1,351 |
$59K |
| J2778 |
Injection, ranibizumab, 0.1 mg |
73 |
40 |
$22K |
| V2020 |
Frames, purchases |
2,959 |
2,683 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,620 |
1,809 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
46 |
44 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
25 |
$3K |
| 92235 |
|
34 |
28 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,364 |
2,260 |
$1K |
| 92250 |
|
56 |
39 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
43 |
$633.75 |
| V2799 |
Vision item or service, miscellaneous |
350 |
344 |
$25.00 |