| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,411 |
769 |
$356K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,439 |
4,724 |
$204K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,143 |
1,275 |
$166K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,204 |
4,534 |
$145K |
| 11721 |
|
6,128 |
6,053 |
$140K |
| 11056 |
|
2,957 |
2,914 |
$59K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
897 |
894 |
$51K |
| 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 |
643 |
333 |
$26K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
230 |
224 |
$17K |
| 17110 |
|
120 |
116 |
$8K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
32 |
16 |
$3K |
| 11055 |
|
231 |
226 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
469 |
408 |
$2K |
| 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 |
62 |
31 |
$2K |
| 11720 |
|
173 |
172 |
$2K |
| 11057 |
|
42 |
42 |
$891.51 |