| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
27,916 |
14,059 |
$7.99M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30,690 |
26,349 |
$1.58M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,344 |
6,094 |
$519K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
1,401 |
1,350 |
$221K |
| 73630 |
|
8,606 |
6,382 |
$98K |
| A4550 |
Surgical trays |
1,833 |
1,221 |
$84K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,027 |
948 |
$82K |
| 73718 |
|
221 |
206 |
$80K |
| Q4038 |
Cast supplies, short leg cast, adult (11 years +), fiberglass |
250 |
161 |
$60K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
131 |
124 |
$32K |
| 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 |
136 |
120 |
$22K |
| 11750 |
|
180 |
151 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
86 |
84 |
$10K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
203 |
115 |
$6K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
107 |
104 |
$5K |
| L4210 |
Repair of orthotic device, repair or replace minor parts |
156 |
124 |
$5K |
| 29425 |
|
88 |
54 |
$3K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
156 |
146 |
$2K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
17 |
13 |
$1K |
| 20550 |
|
51 |
50 |
$1K |
| 11721 |
|
126 |
94 |
$1K |
| 11056 |
|
152 |
115 |
$745.90 |
| 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 |
93 |
68 |
$535.38 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$346.36 |
| 29700 |
|
30 |
26 |
$218.99 |
| 73620 |
|
23 |
15 |
$172.40 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
26 |
26 |
$156.22 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
13 |
12 |
$15.63 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
13 |
$1.80 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
14 |
14 |
$1.64 |