| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,061 |
1,048 |
$97K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
206 |
205 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
622 |
619 |
$21K |
| 99215 |
Prolong outpt/office vis |
72 |
72 |
$2K |
| 76376 |
|
99 |
96 |
$789.12 |
| 93880 |
|
25 |
25 |
$729.34 |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
14 |
14 |
$224.03 |
| A9578 |
Injection, gadobenate dimeglumine (multihance multipack), per ml |
260 |
258 |
$177.13 |
| J7050 |
Infusion, normal saline solution, 250 cc |
22 |
22 |
$4.62 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
216 |
213 |
$0.00 |