| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,736 |
7,859 |
$352K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,611 |
1,577 |
$134K |
| 95923 |
|
978 |
950 |
$47K |
| 73630 |
|
1,965 |
1,494 |
$45K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
885 |
423 |
$36K |
| 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 |
968 |
462 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,301 |
1,169 |
$32K |
| 20550 |
|
549 |
400 |
$22K |
| 11750 |
|
108 |
81 |
$15K |
| 11721 |
|
877 |
820 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
81 |
76 |
$9K |
| S9999 |
Sales tax |
604 |
517 |
$6K |
| 20605 |
|
143 |
121 |
$4K |
| 73620 |
|
180 |
113 |
$4K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
137 |
75 |
$3K |
| 93923 |
|
53 |
53 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,404 |
1,335 |
$3K |
| 97597 |
|
89 |
36 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$1K |
| 64450 |
|
17 |
13 |
$1K |
| 29581 |
|
60 |
32 |
$1K |
| J1110 |
Injection, dihydroergotamine mesylate, per 1 mg |
301 |
288 |
$644.46 |
| 11000 |
|
14 |
12 |
$376.75 |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
49 |
26 |
$291.66 |
| L3260 |
Surgical boot/shoe, each |
12 |
12 |
$137.21 |
| A6456 |
Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
49 |
30 |
$105.09 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
672 |
638 |
$104.72 |
| A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
60 |
38 |
$58.06 |
| 99024 |
|
17 |
12 |
$0.00 |