| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,781 |
2,407 |
$143K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
751 |
399 |
$63K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
903 |
835 |
$28K |
| L3410 |
Metatarsal bar wedge, between sole |
442 |
288 |
$26K |
| 76000 |
|
436 |
418 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
250 |
250 |
$19K |
| 11721 |
|
788 |
777 |
$19K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
298 |
199 |
$14K |
| 11730 |
|
286 |
278 |
$14K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
44 |
41 |
$11K |
| L3485 |
Heel, pad, removable for spur |
459 |
295 |
$11K |
| 29540 |
|
187 |
144 |
$3K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
36 |
32 |
$3K |
| 11755 |
|
41 |
40 |
$2K |
| 99072 |
|
153 |
132 |
$2K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
77 |
39 |
$2K |
| 73620 |
|
77 |
39 |
$1K |
| 11056 |
|
40 |
37 |
$1K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
13 |
12 |
$948.64 |
| 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 |
27 |
14 |
$444.00 |
| 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 |
27 |
14 |
$270.00 |
| 97760 |
|
15 |
15 |
$50.00 |