| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11721 |
|
17,963 |
17,567 |
$137K |
| 11305 |
|
1,308 |
953 |
$22K |
| 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 |
205 |
135 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
146 |
130 |
$5K |
| 11056 |
|
127 |
127 |
$2K |
| 11720 |
|
197 |
196 |
$917.42 |
| 11055 |
|
16 |
13 |
$151.84 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
13 |
12 |
$0.00 |
| 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 |
205 |
135 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
16 |
15 |
$0.00 |