| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,071 |
1,905 |
$89K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
146 |
145 |
$11K |
| 73630 |
|
432 |
320 |
$9K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
26 |
13 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$419.08 |