| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
339 |
155 |
$24K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
694 |
318 |
$15K |
| 11721 |
|
2,044 |
1,896 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
357 |
321 |
$5K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
65 |
28 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
412 |
398 |
$3K |
| 11056 |
|
663 |
595 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$605.15 |
| 11765 |
|
52 |
51 |
$556.59 |
| 20550 |
|
16 |
12 |
$382.50 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$340.94 |
| 29540 |
|
24 |
24 |
$232.06 |
| 11730 |
|
26 |
25 |
$82.50 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
45 |
31 |
$29.16 |
| 11720 |
|
12 |
12 |
$22.05 |
| 99072 |
|
37 |
34 |
$0.00 |
| 11719 |
|
12 |
12 |
$0.00 |