| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
835 |
470 |
$117K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,830 |
1,829 |
$82K |
| 11720 |
|
4,704 |
4,595 |
$79K |
| 17110 |
|
1,109 |
1,037 |
$63K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,550 |
3,415 |
$59K |
| 11056 |
|
3,319 |
3,272 |
$52K |
| L3260 |
Surgical boot/shoe, each |
911 |
665 |
$48K |
| 11043 |
|
389 |
169 |
$45K |
| 11750 |
|
423 |
234 |
$28K |
| 73630 |
|
1,334 |
1,049 |
$26K |
| 93922 |
|
210 |
207 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
159 |
158 |
$6K |
| 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 |
56 |
54 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
37 |
$990.94 |