| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,501 |
10,576 |
$196K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
742 |
366 |
$159K |
| 11721 |
|
3,886 |
3,820 |
$89K |
| 73630 |
|
3,301 |
2,068 |
$72K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
860 |
859 |
$50K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,616 |
1,605 |
$47K |
| 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 |
333 |
300 |
$35K |
| 99205 |
Prolong outpt/office vis |
407 |
403 |
$34K |
| 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 |
427 |
308 |
$30K |
| 11750 |
|
453 |
367 |
$29K |
| 20550 |
|
803 |
613 |
$28K |
| 29799 |
|
809 |
435 |
$17K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
77 |
57 |
$6K |
| 11056 |
|
346 |
337 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
298 |
284 |
$3K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
537 |
511 |
$3K |
| 11755 |
|
48 |
48 |
$3K |
| 95851 |
|
142 |
69 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
74 |
72 |
$1K |
| 29515 |
|
22 |
13 |
$700.32 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21 |
20 |
$318.36 |
| 1100F |
|
13 |
13 |
$0.00 |