| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Ft insert ucb berkeley shell |
3,785 |
1,629 |
$698K |
| 99213 |
|
7,027 |
5,641 |
$287K |
| 99203 |
|
2,142 |
1,930 |
$118K |
| L3216 |
Orthoped ladies shoes dpth i |
1,278 |
531 |
$72K |
| 99212 |
|
1,724 |
1,484 |
$44K |
| 17110 |
|
1,337 |
990 |
$41K |
| 11721 |
|
2,654 |
2,185 |
$23K |
| L3221 |
Orthopedic mens shoes dpth i |
336 |
125 |
$19K |
| 73630 |
|
273 |
236 |
$6K |
| S0395 |
Impression casting ft |
123 |
102 |
$5K |
| 11755 |
|
72 |
57 |
$4K |
| L4397 |
Static or dynami afo pre ots |
30 |
27 |
$4K |
| 97597 |
|
61 |
37 |
$3K |
| 99214 |
|
27 |
24 |
$2K |
| A5500 |
Diab shoe for density insert |
174 |
56 |
$2K |
| L1906 |
Afo multilig ank sup pre ots |
14 |
12 |
$1K |
| 64455 |
|
165 |
112 |
$917.10 |
| A5514 |
Mult den insert dir carv/cam |
58 |
17 |
$802.90 |
| 11056 |
|
85 |
64 |
$797.00 |
| 11720 |
|
57 |
47 |
$471.72 |
| 73620 |
|
18 |
15 |
$412.67 |
| A5512 |
Multi den insert direct form |
34 |
12 |
$390.58 |
| G0127 |
Trim nail(s) |
74 |
63 |
$290.50 |
| 93922 |
|
16 |
12 |
$262.15 |
| 11055 |
|
22 |
19 |
$253.66 |
| 29550 |
|
43 |
32 |
$163.07 |
| J3301 |
Triamcinolone acet inj nos |
160 |
108 |
$91.94 |
| A4580 |
Cast supplies (plaster) |
119 |
102 |
$45.00 |
| J1100 |
Dexamethasone sodium phos |
30 |
25 |
$12.40 |
| G8427 |
Docrev cur meds by elig clin |
3,002 |
2,337 |
$6.24 |
| 1124F |
|
732 |
574 |
$1.11 |
| J3420 |
Vitamin b12 injection |
123 |
51 |
$0.28 |
| 1036F |
|
2,069 |
1,630 |
$0.00 |
| G9903 |
Pt scrn tbco id as non user |
2,609 |
2,015 |
$0.00 |
| G9902 |
Pt scrn tbco and id as user |
200 |
161 |
$0.00 |
| G8410 |
Eval on foot documented |
976 |
752 |
$0.00 |
| G9906 |
Pt recv tbco cess interv |
237 |
192 |
$0.00 |
| G8950 |
Pre-htn or htn doc, f/u indc |
565 |
463 |
$0.00 |
| G8404 |
Low extemity neur exam docum |
980 |
754 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
1,180 |
914 |
$0.00 |
| 4004F |
|
165 |
132 |
$0.00 |