| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
1,256 |
667 |
$186K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,202 |
3,131 |
$181K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,526 |
1,523 |
$130K |
| 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 |
2,312 |
1,307 |
$82K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,253 |
1,223 |
$46K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
77 |
76 |
$42K |
| 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 |
904 |
511 |
$37K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
524 |
307 |
$26K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
90 |
55 |
$6K |
| 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 |
178 |
89 |
$5K |
| 11721 |
|
157 |
155 |
$4K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
55 |
39 |
$4K |
| 20550 |
|
35 |
32 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
192 |
171 |
$264.95 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
202 |
178 |
$19.94 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
289 |
252 |
$0.92 |