| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36,134 |
30,826 |
$934K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
6,249 |
3,110 |
$818K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
11,085 |
10,191 |
$648K |
| 11721 |
|
39,119 |
34,137 |
$461K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,930 |
9,330 |
$420K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
4,213 |
3,702 |
$313K |
| 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 |
9,205 |
5,118 |
$295K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
1,071 |
1,022 |
$221K |
| 73630 |
|
9,486 |
8,009 |
$192K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
2,089 |
1,196 |
$187K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
3,601 |
2,496 |
$183K |
| L2330 |
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
836 |
519 |
$150K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
2,968 |
1,877 |
$126K |
| 20550 |
|
2,602 |
2,132 |
$121K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
812 |
789 |
$108K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
4,887 |
3,060 |
$94K |
| 11056 |
|
8,896 |
7,371 |
$67K |
| 17110 |
|
3,190 |
2,459 |
$63K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,506 |
688 |
$50K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
1,405 |
722 |
$46K |
| 11750 |
|
598 |
471 |
$44K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
75 |
48 |
$29K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
683 |
453 |
$27K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
93 |
57 |
$22K |
| 99215 |
Prolong outpt/office vis |
168 |
147 |
$11K |
| 20600 |
|
517 |
364 |
$10K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,243 |
401 |
$10K |
| 93923 |
|
228 |
215 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
367 |
314 |
$7K |
| 20610 |
|
140 |
120 |
$6K |
| K0903 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
44 |
44 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
127 |
117 |
$5K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
86 |
76 |
$3K |
| 73610 |
|
82 |
80 |
$3K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
6,657 |
5,392 |
$3K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
97 |
75 |
$2K |
| 11730 |
|
78 |
69 |
$2K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
18 |
13 |
$2K |
| 99205 |
Prolong outpt/office vis |
15 |
14 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,524 |
2,149 |
$2K |
| 97162 |
|
55 |
50 |
$2K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
16 |
12 |
$1K |
| 11055 |
|
212 |
188 |
$1K |
| 87481 |
|
94 |
74 |
$1K |
| 73650 |
|
42 |
38 |
$1K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
217 |
195 |
$929.98 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
66 |
56 |
$542.68 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
83 |
71 |
$395.03 |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
14 |
13 |
$247.22 |
| 20605 |
|
19 |
15 |
$244.96 |
| 73560 |
|
13 |
12 |
$240.14 |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
227 |
118 |
$231.96 |
| 17250 |
|
62 |
39 |
$162.44 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
15 |
14 |
$154.04 |
| 11720 |
|
23 |
18 |
$74.24 |
| 11719 |
|
41 |
24 |
$62.19 |
| G0127 |
Trimming of dystrophic nails, any number |
24 |
19 |
$10.73 |
| 1100F |
|
231 |
213 |
$0.00 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
27 |
26 |
$0.00 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
27 |
25 |
$0.00 |