| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,458 |
688 |
$185K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,399 |
2,841 |
$158K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,099 |
1,778 |
$57K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
435 |
392 |
$26K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
246 |
239 |
$12K |
| 11730 |
|
436 |
393 |
$9K |
| 73630 |
|
348 |
211 |
$4K |
| Q4038 |
Cast supplies, short leg cast, adult (11 years +), fiberglass |
254 |
240 |
$3K |
| 11057 |
|
717 |
654 |
$3K |
| 11720 |
|
769 |
704 |
$2K |
| 11732 |
|
382 |
343 |
$2K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
19 |
15 |
$1K |
| 95851 |
|
62 |
31 |
$534.00 |
| 11719 |
|
795 |
702 |
$501.96 |
| A4580 |
Cast supplies (e.g., plaster) |
21 |
17 |
$67.50 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
14 |
12 |
$6.55 |
| Q4037 |
Cast supplies, short leg cast, adult (11 years +), plaster |
34 |
30 |
$0.00 |