| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
7,933 |
7,897 |
$417K |
| 11721 |
|
13,173 |
13,068 |
$327K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,445 |
722 |
$247K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,396 |
9,752 |
$243K |
| 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 |
2,412 |
2,369 |
$234K |
| 11750 |
|
3,051 |
2,179 |
$201K |
| 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 |
2,501 |
2,460 |
$201K |
| L3260 |
Surgical boot/shoe, each |
1,571 |
1,142 |
$43K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
310 |
216 |
$26K |
| 20550 |
|
613 |
444 |
$24K |
| 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 |
141 |
139 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
164 |
164 |
$11K |
| 20551 |
|
46 |
37 |
$2K |
| 11056 |
|
89 |
89 |
$2K |
| 11720 |
|
209 |
207 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$491.58 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$118.59 |