| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
905 |
793 |
$387K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,337 |
5,631 |
$166K |
| 11721 |
|
4,249 |
4,229 |
$150K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,402 |
859 |
$149K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,486 |
1,238 |
$61K |
| 11056 |
|
1,612 |
1,602 |
$43K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
317 |
317 |
$24K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
130 |
116 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
131 |
131 |
$8K |
| 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 |
13 |
13 |
$2K |
| 93925 |
|
13 |
13 |
$1K |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
46 |
$931.35 |
| 93922 |
|
12 |
12 |
$680.88 |
| 73630 |
|
18 |
12 |
$475.20 |
| 11055 |
|
29 |
26 |
$427.96 |