| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,873 |
2,715 |
$89K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
234 |
234 |
$23K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
28 |
14 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67 |
65 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$2K |
| 11721 |
|
31 |
31 |
$1K |
| 73630 |
|
86 |
29 |
$1K |
| 11056 |
|
12 |
12 |
$440.52 |
| 95851 |
|
24 |
12 |
$160.50 |
| A4580 |
Cast supplies (e.g., plaster) |
12 |
12 |
$139.47 |