| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,956 |
1,956 |
$177K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,328 |
2,264 |
$158K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
663 |
647 |
$28K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
27 |
27 |
$3K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
16 |
16 |
$3K |
| 11721 |
|
79 |
79 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
139 |
139 |
$67.50 |
| 99051 |
|
16 |
16 |
$19.08 |
| 1000F |
|
101 |
101 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
69 |
69 |
$0.00 |
| 1036F |
|
84 |
84 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
17 |
17 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
31 |
31 |
$0.00 |
| 3016F |
|
31 |
31 |
$0.00 |
| 3725F |
|
131 |
131 |
$0.00 |