| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,509 |
702 |
$346K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,175 |
4,424 |
$299K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
844 |
821 |
$61K |
| 73620 |
|
2,208 |
1,497 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
462 |
411 |
$38K |
| 73630 |
|
1,378 |
774 |
$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 |
146 |
104 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
138 |
121 |
$15K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
37 |
37 |
$9K |
| 20605 |
|
240 |
209 |
$9K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
102 |
49 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82 |
73 |
$3K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
94 |
40 |
$2K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
28 |
14 |
$2K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
14 |
14 |
$2K |
| 11721 |
|
76 |
74 |
$1K |
| 99221 |
|
14 |
14 |
$413.54 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
16 |
13 |
$26.60 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
12 |
$2.91 |
| 97760 |
|
17 |
16 |
$0.00 |