| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,298 |
4,703 |
$137K |
| 11721 |
|
4,558 |
4,469 |
$109K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,706 |
4,152 |
$88K |
| 11056 |
|
3,030 |
2,920 |
$57K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
626 |
626 |
$30K |
| 29540 |
|
918 |
681 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
112 |
112 |
$5K |
| 11000 |
|
428 |
401 |
$5K |
| 11057 |
|
201 |
198 |
$3K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
30 |
12 |
$2K |
| 11720 |
|
160 |
158 |
$2K |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$330.80 |
| 11055 |
|
13 |
12 |
$200.32 |
| 29550 |
|
19 |
15 |
$58.47 |
| 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 |
24 |
12 |
$0.00 |