| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,226 |
7,906 |
$209K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
625 |
411 |
$176K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,441 |
2,431 |
$133K |
| 11721 |
|
2,682 |
2,677 |
$75K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, 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 |
751 |
231 |
$31K |
| 93922 |
|
571 |
571 |
$21K |
| 11720 |
|
1,369 |
1,366 |
$18K |
| 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 |
371 |
249 |
$18K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
186 |
80 |
$18K |
| 11056 |
|
730 |
725 |
$16K |
| L3260 |
Surgical boot/shoe, each |
118 |
104 |
$8K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
49 |
49 |
$6K |
| 97597 |
|
202 |
96 |
$5K |
| 11750 |
|
67 |
57 |
$5K |
| 29540 |
|
109 |
100 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
145 |
145 |
$2K |
| 11055 |
|
107 |
107 |
$1K |
| 29580 |
|
14 |
12 |
$444.01 |