| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,434 |
8,552 |
$216K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,517 |
1,302 |
$108K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
270 |
158 |
$6K |
| 73630 |
|
1,854 |
868 |
$5K |
| 10060 |
|
143 |
115 |
$4K |
| 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 |
282 |
95 |
$2K |
| 73620 |
|
1,464 |
687 |
$2K |
| 11721 |
|
5,224 |
3,724 |
$2K |
| 11420 |
|
14 |
13 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$809.79 |
| 29580 |
|
161 |
108 |
$569.02 |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, 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 |
250 |
83 |
$418.14 |
| 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 |
42 |
12 |
$272.18 |
| 20550 |
|
14 |
12 |
$69.88 |
| 11057 |
|
39 |
37 |
$39.56 |
| 1036F |
|
372 |
309 |
$23.42 |
| 73610 |
|
30 |
13 |
$18.45 |
| 4040F |
|
405 |
337 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
405 |
337 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
201 |
167 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
405 |
337 |
$0.00 |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
26 |
12 |
$0.00 |