| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q4205 |
Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) |
3,189 |
830 |
$37.38M |
| Q4253 |
Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) |
69 |
29 |
$1.39M |
| 15275 |
|
3,466 |
916 |
$270K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,775 |
6,393 |
$196K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,151 |
395 |
$106K |
| 99205 |
Prolong outpt/office vis |
1,005 |
1,005 |
$76K |
| 11721 |
|
3,310 |
3,281 |
$71K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
929 |
929 |
$59K |
| 11750 |
|
487 |
394 |
$54K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
239 |
121 |
$53K |
| 99215 |
Prolong outpt/office vis |
847 |
790 |
$45K |
| 11056 |
|
1,516 |
1,503 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,150 |
1,034 |
$25K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
315 |
314 |
$19K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
70 |
69 |
$11K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
51 |
27 |
$5K |
| 99442 |
|
73 |
73 |
$879.61 |
| 99443 |
|
12 |
12 |
$393.60 |