| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3020 |
Foot longitud/metatarsal sup |
2,346 |
1,344 |
$255K |
| 73630 |
|
12,721 |
8,324 |
$192K |
| 99212 |
|
8,935 |
8,039 |
$179K |
| 99213 |
|
3,676 |
3,288 |
$118K |
| 11721 |
|
6,507 |
6,128 |
$83K |
| L4360 |
Pneumat walking boot pre cst |
478 |
461 |
$64K |
| 99202 |
|
1,880 |
1,783 |
$58K |
| A5500 |
Diab shoe for density insert |
978 |
640 |
$41K |
| 73610 |
|
2,227 |
1,695 |
$35K |
| 99203 |
|
647 |
596 |
$28K |
| 11042 |
|
779 |
520 |
$23K |
| A4590 |
Special casting material |
1,083 |
971 |
$20K |
| 17110 |
|
447 |
382 |
$20K |
| 11720 |
|
2,158 |
2,081 |
$12K |
| 20550 |
|
392 |
279 |
$12K |
| L4396 |
Static or dynami afo pre cst |
114 |
107 |
$10K |
| 73620 |
|
599 |
438 |
$9K |
| 11055 |
|
752 |
696 |
$4K |
| L4350 |
Ankle control ortho pre ots |
76 |
74 |
$4K |
| 11056 |
|
221 |
209 |
$4K |
| 73600 |
|
258 |
206 |
$4K |
| J3301 |
Triamcinolone acet inj nos |
2,170 |
1,993 |
$3K |
| A5514 |
Mult den insert dir carv/cam |
51 |
28 |
$2K |
| A5512 |
Multi den insert direct form |
126 |
74 |
$2K |
| L1906 |
Afo multilig ank sup pre ots |
29 |
28 |
$2K |
| 20605 |
|
72 |
53 |
$2K |
| 97597 |
|
60 |
50 |
$1K |
| 20600 |
|
28 |
24 |
$624.91 |
| 93922 |
|
12 |
12 |
$523.82 |
| J1100 |
Dexamethasone sodium phos |
2,162 |
1,989 |
$248.52 |