| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,963 |
8,217 |
$601K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,006 |
4,268 |
$348K |
| 11721 |
|
6,546 |
5,967 |
$156K |
| 29581 |
|
3,033 |
1,865 |
$110K |
| 17110 |
|
1,740 |
1,450 |
$89K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
496 |
468 |
$68K |
| 73630 |
|
2,512 |
1,661 |
$49K |
| 76882 |
|
2,161 |
1,363 |
$47K |
| 11056 |
|
5,157 |
4,723 |
$40K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
462 |
427 |
$37K |
| 29540 |
|
1,992 |
1,475 |
$35K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
28 |
25 |
$5K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
16 |
12 |
$5K |
| 76942 |
|
44 |
38 |
$2K |
| 11102 |
|
24 |
24 |
$2K |
| 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 |
146 |
76 |
$2K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
71 |
50 |
$1K |
| 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 |
68 |
39 |
$1K |
| 20550 |
|
32 |
27 |
$1K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
14 |
12 |
$787.22 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
15 |
$574.68 |
| 11755 |
|
37 |
37 |
$0.00 |
| 11057 |
|
27 |
27 |
$0.00 |