| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,461 |
2,247 |
$196K |
| 11721 |
|
1,198 |
1,196 |
$44K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
420 |
420 |
$44K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
237 |
219 |
$10K |
| 11056 |
|
152 |
151 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
50 |
$6K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
54 |
37 |
$4K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
12 |
12 |
$1K |
| 97597 |
|
13 |
12 |
$769.19 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
16 |
12 |
$618.08 |
| 11720 |
|
25 |
25 |
$572.13 |
| 73630 |
|
16 |
12 |
$225.44 |