| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,629 |
2,251 |
$218K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,094 |
781 |
$94K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
298 |
188 |
$68K |
| Q4050 |
Cast supplies, for unlisted types and materials of casts |
255 |
185 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
70 |
57 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
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 |
20 |
12 |
$1K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
16 |
12 |
$1K |
| L3540 |
Orthopedic shoe addition, sole, full |
19 |
14 |
$1K |
| S0395 |
Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic |
146 |
114 |
$504.00 |
| 73630 |
|
15 |
12 |
$333.76 |
| 29540 |
|
16 |
12 |
$296.52 |