| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
220 |
174 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
185 |
153 |
$6K |
| 99349 |
|
738 |
693 |
$4K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
128 |
112 |
$2K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
50 |
21 |
$2K |
| 99348 |
|
53 |
51 |
$2K |
| 93922 |
|
53 |
47 |
$2K |
| 11750 |
|
34 |
26 |
$861.05 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
13 |
13 |
$627.74 |
| 76882 |
|
18 |
12 |
$354.28 |
| 99350 |
Prolong home eval add 15m |
129 |
127 |
$216.71 |
| 11721 |
|
327 |
320 |
$195.84 |
| 1036F |
|
746 |
711 |
$0.00 |