| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,795 |
2,750 |
$73K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
894 |
894 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,004 |
997 |
$43K |
| 11721 |
|
1,542 |
1,542 |
$27K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
24 |
12 |
$6K |
| 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 |
24 |
12 |
$1K |
| 73630 |
|
48 |
40 |
$833.78 |
| 11420 |
|
24 |
24 |
$101.85 |