| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
670 |
305 |
$159K |
| 28899 |
|
275 |
206 |
$87K |
| V2790 |
Amniotic membrane for surgical reconstruction, per procedure |
12 |
12 |
$65K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,341 |
1,708 |
$57K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
592 |
579 |
$35K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
101 |
70 |
$35K |
| 20550 |
|
500 |
368 |
$33K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
274 |
138 |
$30K |
| L2210 |
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
251 |
126 |
$17K |
| 29799 |
|
81 |
78 |
$16K |
| 99070 |
|
264 |
260 |
$7K |
| 97760 |
|
74 |
71 |
$7K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
25 |
24 |
$5K |
| 11721 |
|
696 |
690 |
$4K |
| 99215 |
Prolong outpt/office vis |
44 |
41 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
112 |
95 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
16 |
$1K |
| 95831 |
|
53 |
51 |
$858.07 |
| 11056 |
|
185 |
185 |
$501.40 |