| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
101 |
74 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
72 |
64 |
$5K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
24 |
24 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
73 |
63 |
$3K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
17 |
14 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
17 |
14 |
$308.23 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$163.78 |