| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
2,346 |
1,344 |
$255K |
| 73630 |
|
12,721 |
8,324 |
$192K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,935 |
8,039 |
$179K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,676 |
3,288 |
$118K |
| 11721 |
|
6,507 |
6,128 |
$83K |
| 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 |
478 |
461 |
$64K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,880 |
1,783 |
$58K |
| 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 |
978 |
640 |
$41K |
| 73610 |
|
2,227 |
1,695 |
$35K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
647 |
596 |
$28K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
779 |
520 |
$23K |
| A4590 |
Special casting material (e.g., fiberglass) |
1,083 |
971 |
$20K |
| 17110 |
|
447 |
382 |
$20K |
| 11720 |
|
2,158 |
2,081 |
$12K |
| 20550 |
|
392 |
279 |
$12K |
| 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 |
114 |
107 |
$10K |
| 73620 |
|
599 |
438 |
$9K |
| 11055 |
|
752 |
696 |
$4K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
76 |
74 |
$4K |
| 11056 |
|
221 |
209 |
$4K |
| 73600 |
|
258 |
206 |
$4K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
2,170 |
1,993 |
$3K |
| 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 |
51 |
28 |
$2K |
| 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 |
126 |
74 |
$2K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
29 |
28 |
$2K |
| 20605 |
|
72 |
53 |
$2K |
| 97597 |
|
60 |
50 |
$1K |
| 20600 |
|
28 |
24 |
$624.91 |
| 93922 |
|
12 |
12 |
$523.82 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,162 |
1,989 |
$248.52 |