| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
5,461 |
2,928 |
$1.34M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23,854 |
20,288 |
$922K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
8,262 |
7,532 |
$505K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,220 |
4,242 |
$316K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
2,251 |
1,141 |
$261K |
| 11720 |
|
21,446 |
18,771 |
$225K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,369 |
6,686 |
$185K |
| 20550 |
|
4,682 |
2,898 |
$139K |
| 11750 |
|
1,753 |
1,083 |
$136K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,362 |
1,166 |
$128K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
482 |
439 |
$110K |
| 11721 |
|
6,922 |
6,023 |
$99K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
842 |
384 |
$93K |
| 11730 |
|
1,261 |
1,119 |
$82K |
| 36465 |
|
189 |
129 |
$81K |
| 73630 |
|
4,030 |
2,879 |
$77K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,857 |
1,701 |
$76K |
| 87150 |
|
327 |
291 |
$71K |
| 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 |
1,440 |
627 |
$71K |
| 97597 |
|
961 |
572 |
$54K |
| 73620 |
|
2,446 |
1,774 |
$53K |
| 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 |
958 |
393 |
$52K |
| 11056 |
|
1,534 |
1,214 |
$51K |
| Q4101 |
Apligraf, per square centimeter (add-on, list separately in addition to primary procedure) |
96 |
12 |
$50K |
| 17110 |
|
682 |
492 |
$44K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
4,305 |
3,560 |
$35K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
140 |
126 |
$31K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
232 |
221 |
$31K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,820 |
1,661 |
$29K |
| 15275 |
|
583 |
160 |
$25K |
| 87481 |
|
570 |
522 |
$23K |
| 93970 |
|
274 |
251 |
$22K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
385 |
262 |
$22K |
| 11719 |
|
2,162 |
1,602 |
$13K |
| 99223 |
Prolong inpt eval add15 m |
93 |
72 |
$9K |
| 73610 |
|
395 |
312 |
$8K |
| 11055 |
|
248 |
198 |
$7K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
131 |
117 |
$4K |
| G9458 |
Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user |
307 |
290 |
$3K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
1,424 |
984 |
$3K |
| 87081 |
|
320 |
284 |
$2K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
35 |
15 |
$2K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
22 |
12 |
$639.08 |
| J1020 |
Injection, methylprednisolone acetate, 20 mg |
19 |
12 |
$77.34 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
25 |
12 |
$71.18 |
| G0127 |
Trimming of dystrophic nails, any number |
98 |
55 |
$28.87 |