| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,008 |
7,515 |
$242K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,202 |
2,022 |
$105K |
| 73620 |
|
935 |
520 |
$19K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
48 |
24 |
$8K |
| 64450 |
|
217 |
164 |
$5K |
| 73630 |
|
118 |
92 |
$3K |
| 10061 |
|
15 |
13 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
42 |
$2K |
| 64455 |
|
30 |
26 |
$480.55 |
| 95851 |
|
174 |
171 |
$16.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
305 |
260 |
$0.00 |
| 99024 |
|
18 |
12 |
$0.00 |
| A4550 |
Surgical trays |
232 |
195 |
$0.00 |