| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
3,545 |
1,726 |
$940K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,966 |
7,035 |
$328K |
| 73630 |
|
6,941 |
5,204 |
$124K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,910 |
1,661 |
$118K |
| 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 |
703 |
356 |
$77K |
| Q4038 |
Cast supplies, short leg cast, adult (11 years +), fiberglass |
1,762 |
1,326 |
$66K |
| 11721 |
|
4,643 |
4,476 |
$65K |
| 76942 |
|
1,504 |
1,046 |
$45K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
819 |
744 |
$41K |
| 11057 |
|
1,563 |
1,464 |
$39K |
| 20550 |
|
1,357 |
728 |
$39K |
| 11056 |
|
806 |
703 |
$17K |
| 73610 |
|
1,067 |
904 |
$16K |
| 20604 |
|
222 |
203 |
$14K |
| 29540 |
|
1,116 |
1,021 |
$14K |
| 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 |
252 |
134 |
$13K |
| 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 |
243 |
119 |
$11K |
| 73620 |
|
950 |
798 |
$11K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
147 |
77 |
$8K |
| 20600 |
|
246 |
223 |
$7K |
| L2330 |
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
57 |
26 |
$6K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
24 |
24 |
$6K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
42 |
25 |
$6K |
| 99215 |
Prolong outpt/office vis |
68 |
53 |
$6K |
| 93922 |
|
126 |
119 |
$5K |
| 76882 |
|
86 |
75 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
27 |
$3K |
| 20605 |
|
65 |
52 |
$2K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
48 |
24 |
$2K |
| 64640 |
|
99 |
67 |
$2K |
| 11750 |
|
12 |
12 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
73 |
68 |
$2K |
| 95923 |
|
27 |
25 |
$1K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
517 |
415 |
$49.05 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
16 |
12 |
$30.51 |