| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q4205 |
Membrane graft or wrap sq cm |
322 |
133 |
$1.90M |
| 99213 |
|
14,507 |
12,713 |
$393K |
| L3000 |
Ft insert ucb berkeley shell |
1,107 |
968 |
$388K |
| 11750 |
|
1,448 |
1,192 |
$203K |
| Q4131 |
Epifix or epicord |
80 |
38 |
$201K |
| 99203 |
|
3,210 |
3,202 |
$197K |
| 11721 |
|
5,205 |
5,049 |
$140K |
| L1906 |
Afo multilig ank sup pre ots |
739 |
672 |
$109K |
| 11056 |
|
4,767 |
4,641 |
$101K |
| L2820 |
Soft interface below knee se |
627 |
569 |
$68K |
| L2397 |
Suspension sleeve lower ext |
649 |
591 |
$63K |
| 99215 |
Prolong outpt/office vis |
868 |
791 |
$49K |
| L4396 |
Static or dynami afo pre cst |
263 |
256 |
$44K |
| 99205 |
Prolong outpt/office vis |
440 |
436 |
$36K |
| 99214 |
|
1,025 |
941 |
$31K |
| 15275 |
|
521 |
239 |
$22K |
| L4360 |
Pneumat walking boot pre cst |
66 |
65 |
$10K |
| 93925 |
|
67 |
67 |
$6K |
| A5500 |
Diab shoe for density insert |
68 |
68 |
$6K |
| A5513 |
Multi den insert custom mold |
68 |
68 |
$4K |
| 11042 |
|
58 |
38 |
$3K |
| 99212 |
|
466 |
414 |
$2K |
| 99204 |
|
24 |
24 |
$2K |
| J3490 |
Drugs unclassified injection |
101 |
98 |
$29.93 |