| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
6,720 |
3,222 |
$230K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,024 |
2,789 |
$149K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,144 |
4,369 |
$114K |
| 11721 |
|
7,932 |
7,378 |
$91K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
451 |
376 |
$5K |
| 11056 |
|
324 |
301 |
$4K |
| 11750 |
|
68 |
26 |
$3K |
| 73630 |
|
270 |
207 |
$3K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 |
67 |
32 |
$1K |
| 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 |
48 |
37 |
$774.16 |
| K0903 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 |
69 |
45 |
$97.50 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
17 |
12 |
$24.93 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
17 |
12 |
$5.86 |
| 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 |
14 |
13 |
$0.00 |