| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
3,870 |
1,939 |
$355K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,469 |
6,070 |
$157K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,383 |
1,334 |
$57K |
| 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 |
1,371 |
685 |
$44K |
| 73630 |
|
1,538 |
1,077 |
$27K |
| 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 |
616 |
288 |
$15K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
100 |
76 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
33 |
32 |
$2K |
| 11721 |
|
248 |
243 |
$2K |
| 11056 |
|
136 |
134 |
$2K |
| 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 |
19 |
12 |
$2K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
26 |
25 |
$1K |
| 11720 |
|
227 |
223 |
$812.94 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$736.52 |