| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
763 |
760 |
$326K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,526 |
7,170 |
$292K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,384 |
10,898 |
$274K |
| 11750 |
|
1,370 |
1,340 |
$186K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
1,752 |
1,175 |
$160K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,132 |
2,121 |
$136K |
| 20550 |
|
2,427 |
2,386 |
$132K |
| 11721 |
|
4,659 |
4,622 |
$130K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,268 |
2,265 |
$119K |
| 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 |
1,219 |
753 |
$111K |
| 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 |
1,413 |
877 |
$74K |
| 99205 |
Prolong outpt/office vis |
754 |
749 |
$62K |
| 99215 |
Prolong outpt/office vis |
756 |
683 |
$42K |
| 11056 |
|
2,077 |
2,047 |
$39K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
62 |
61 |
$24K |
| 73630 |
|
623 |
612 |
$21K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
14 |
13 |
$1K |
| L3260 |
Surgical boot/shoe, each |
12 |
12 |
$926.32 |