| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
201 |
155 |
$214K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
2,033 |
1,561 |
$101K |
| J2778 |
Injection, ranibizumab, 0.1 mg |
222 |
150 |
$101K |
| 92134 |
|
3,200 |
2,516 |
$48K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,389 |
1,092 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
102 |
95 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
47 |
38 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
24 |
$1K |
| 92201 |
|
72 |
54 |
$852.97 |
| J9035 |
Injection, bevacizumab, 10 mg |
16 |
13 |
$813.08 |