| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,963 |
4,865 |
$201K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
411 |
392 |
$12K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
16 |
12 |
$6K |
| 99215 |
Prolong outpt/office vis |
101 |
94 |
$4K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
12 |
12 |
$489.55 |