Follow-up visit with a doctor

What the hospital lists

• OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN

  Outpatient · hospital charge

  Note from the file: Packaged/Bundled or Carrier Priced Code is not considered to be a service package on its own, but can be part of a service package and included within allowed amounts for service package items (DRG's, Surgical HCPCS)

  $97.50

Location and source

What the hospital lists

• HC OFFICE OUTPATIENT VISIT EST LEVEL 3

  Outpatient · hospital charge

  Note from the file: No services performed during 15-month lookback period.

  $126.00
• HC OFFICE OUTPATIENT VISIT NEW LEVEL 3

  Outpatient · hospital charge

  Note from the file: No services performed during 15-month lookback period.

  $126.00

More than one price is listed. Ask the hospital which one applies to you.

Location and source

What the hospital lists

• Hc Ov Est Pt Level 3

  Inpatient or outpatient · hospital charge

  Note from the file: Gross Charge Type: 155_Hb Op Infusion Ctr Fsc

  $178.00
• Hc Family Summary Conf 20-29Min

  Inpatient or outpatient · hospital charge

  Note from the file: Gross Charge Type: 159_Hb Summa Price Fsc

  $243.50
• Hc Ov Est Pt Level 3

  Inpatient or outpatient · hospital charge

  Note from the file: Gross Charge Type: 157_Hb Clinic Price Fsc

  $243.50

More than one price is listed. Ask the hospital which one applies to you.

Location and source

What the hospital lists

• OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $207.35
• OV EST PT LEVEL 3 M25

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $207.35
• SP OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $207.35
• SU OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  $212.85
• OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $290.95
• OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $305.80
• OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $305.80
• OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $312.95
• EST PAT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: no remit data for previous 12-15 months

  $409.20
• OV EST PT LEVEL 3

  Inpatient or outpatient · hospital charge

  Note from the file: $57 per clinic visit

  $409.20

More than one price is listed. Ask the hospital which one applies to you.

Location and source