| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11306 |
|
3,547 |
3,078 |
$179K |
| 11721 |
|
4,198 |
3,800 |
$62K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,099 |
1,034 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,432 |
1,269 |
$44K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
407 |
328 |
$41K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
520 |
250 |
$30K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
290 |
144 |
$27K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
192 |
95 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
513 |
443 |
$20K |
| 29540 |
|
1,194 |
662 |
$15K |
| 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 |
315 |
153 |
$10K |
| 97760 |
|
167 |
161 |
$7K |
| 11730 |
|
172 |
156 |
$6K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
112 |
55 |
$5K |
| 76881 |
|
68 |
41 |
$5K |
| 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 |
318 |
153 |
$5K |
| 11057 |
|
150 |
132 |
$4K |
| 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 |
25 |
13 |
$2K |
| 11056 |
|
38 |
37 |
$856.95 |
| G0127 |
Trimming of dystrophic nails, any number |
122 |
109 |
$380.35 |
| 11720 |
|
141 |
125 |
$328.12 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$228.98 |