| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,616 |
557 |
$215K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,690 |
3,041 |
$129K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
1,562 |
702 |
$126K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,658 |
1,451 |
$80K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
434 |
193 |
$34K |
| 96001 |
|
1,228 |
1,028 |
$32K |
| 96004 |
|
908 |
758 |
$22K |
| 73630 |
|
1,007 |
868 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
361 |
264 |
$11K |
| 11755 |
|
219 |
189 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
138 |
131 |
$3K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
58 |
26 |
$3K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
34 |
13 |
$1K |
| 11721 |
|
55 |
43 |
$450.70 |