A 64-year old female patient presents to the office complaining of pain and what she describes as a tingling/burning sensation in her extremities that has been occurring for the past several weeks. She is well known and otherwise stable, being managed for DM type 2 and HTN. The physician performs a medically appropriate physical exam and orders a TSH test, vitamin B test, BMP, and A1c test because idiopathic or diabetic peripheral neuropathy leads the differential diagnosis. It is determined that the patient should be evaluated for peripheral neuropathy by a neurologist, and the physician refers the patient for a neurological evaluation while continuing to manage her ongoing, chronic conditions. Which MDM level and E/M code should be reported for this office visit case study?