Questions & corrections
Methodist Hospitals of Dallas · HC CT Abd Pelvis WC
$2,601.00
Source file dated 2026-03-23 · both
Source note: OPPS; APC Pricing (APC Code: 05572 / Adjusted APC Price: 343.46), and; Pricing Extension - HB XR PRC - Tricare OPPS Outlier; Note: No outlier payment added to this line.; Estimated Allowed Amount: 343.46
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