| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
2,456 |
2,036 |
$133K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,732 |
2,455 |
$71K |
| 73630 |
|
1,416 |
720 |
$45K |
| 11721 |
|
2,364 |
2,328 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
556 |
556 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
616 |
564 |
$22K |
| 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 |
731 |
426 |
$21K |
| 29581 |
|
508 |
424 |
$17K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
272 |
137 |
$11K |
| 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 |
682 |
404 |
$10K |
| 11043 |
|
80 |
50 |
$9K |
| 11056 |
|
525 |
505 |
$7K |
| 93924 |
|
108 |
107 |
$4K |
| L3260 |
Surgical boot/shoe, each |
100 |
97 |
$3K |
| 29540 |
|
65 |
58 |
$1K |
| 64450 |
|
46 |
43 |
$901.75 |
| 93922 |
|
29 |
29 |
$864.06 |
| 11750 |
|
14 |
12 |
$336.56 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$176.19 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$0.00 |
| 97597 |
|
17 |
14 |
$0.00 |