| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
3,785 |
1,629 |
$698K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,027 |
5,641 |
$287K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,142 |
1,930 |
$118K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
1,278 |
531 |
$72K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,724 |
1,484 |
$44K |
| 17110 |
|
1,337 |
990 |
$41K |
| 11721 |
|
2,654 |
2,185 |
$23K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
336 |
125 |
$19K |
| 73630 |
|
273 |
236 |
$6K |
| S0395 |
Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic |
123 |
102 |
$5K |
| 11755 |
|
72 |
57 |
$4K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
30 |
27 |
$4K |
| 97597 |
|
61 |
37 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
24 |
$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 |
174 |
56 |
$2K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
14 |
12 |
$1K |
| 64455 |
|
165 |
112 |
$917.10 |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 |
58 |
17 |
$802.90 |
| 11056 |
|
85 |
64 |
$797.00 |
| 11720 |
|
57 |
47 |
$471.72 |
| 73620 |
|
18 |
15 |
$412.67 |
| 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 |
34 |
12 |
$390.58 |
| G0127 |
Trimming of dystrophic nails, any number |
74 |
63 |
$290.50 |
| 93922 |
|
16 |
12 |
$262.15 |
| 11055 |
|
22 |
19 |
$253.66 |
| 29550 |
|
43 |
32 |
$163.07 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
160 |
108 |
$91.94 |
| A4580 |
Cast supplies (e.g., plaster) |
119 |
102 |
$45.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
30 |
25 |
$12.40 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
3,002 |
2,337 |
$6.24 |
| 1124F |
|
732 |
574 |
$1.11 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
123 |
51 |
$0.28 |
| 1036F |
|
2,069 |
1,630 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
2,609 |
2,015 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
200 |
161 |
$0.00 |
| G8410 |
Footwear evaluation performed and documented |
976 |
752 |
$0.00 |
| G9906 |
Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) |
237 |
192 |
$0.00 |
| G8950 |
Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented |
565 |
463 |
$0.00 |
| G8404 |
Lower extremity neurological exam performed and documented |
980 |
754 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,180 |
914 |
$0.00 |
| 4004F |
|
165 |
132 |
$0.00 |