| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,565 |
1,207 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
501 |
336 |
$19K |
| 73630 |
|
730 |
590 |
$13K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
316 |
132 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
111 |
97 |
$4K |
| 11721 |
|
437 |
309 |
$3K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, 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 |
13 |
12 |
$2K |
| 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 |
13 |
12 |
$925.64 |
| 73610 |
|
47 |
39 |
$818.47 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
15 |
13 |
$5.70 |
| S9999 |
Sales tax |
23 |
20 |
$0.06 |