| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,084 |
5,772 |
$359K |
| 73630 |
|
6,598 |
5,590 |
$209K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,886 |
1,885 |
$155K |
| 73610 |
|
3,438 |
3,122 |
$128K |
| 11721 |
|
5,628 |
5,615 |
$109K |
| 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 |
849 |
645 |
$93K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
152 |
152 |
$73K |
| 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 |
821 |
615 |
$48K |
| 11750 |
|
354 |
281 |
$41K |
| 93923 |
|
352 |
351 |
$18K |
| 11056 |
|
498 |
497 |
$14K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
26 |
26 |
$13K |
| 93922 |
|
164 |
164 |
$7K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
86 |
65 |
$7K |
| 11057 |
|
13 |
13 |
$317.32 |