| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,255 |
4,448 |
$194K |
| 73630 |
|
1,814 |
1,497 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,379 |
1,103 |
$28K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
155 |
76 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
408 |
398 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
421 |
372 |
$23K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
167 |
111 |
$10K |
| 11721 |
|
569 |
528 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
82 |
81 |
$7K |
| 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 |
50 |
24 |
$5K |
| 11750 |
|
33 |
28 |
$4K |
| 11720 |
|
334 |
318 |
$4K |
| 29799 |
|
119 |
92 |
$4K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
281 |
242 |
$4K |
| L2210 |
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
21 |
12 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
62 |
57 |
$3K |
| 11719 |
|
546 |
502 |
$2K |
| 11056 |
|
69 |
67 |
$2K |
| 20551 |
|
139 |
50 |
$2K |
| Q4050 |
Cast supplies, for unlisted types and materials of casts |
35 |
26 |
$2K |
| 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 |
24 |
13 |
$825.54 |
| 11057 |
|
14 |
13 |
$685.82 |
| 64450 |
|
26 |
13 |
$568.18 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
259 |
230 |
$161.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$118.26 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
62 |
55 |
$97.58 |
| S0020 |
Injection, bupivicaine hydrochloride, 30 ml |
574 |
420 |
$84.80 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
1,056 |
798 |
$30.54 |
| 99072 |
|
125 |
93 |
$12.00 |
| J3490 |
Unclassified drugs |
13 |
12 |
$8.76 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
206 |
161 |
$0.44 |
| 99002 |
|
356 |
257 |
$0.00 |
| 99000 |
|
16 |
14 |
$0.00 |