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What is the payer reimbursement and the patient charge?

Insurance Plan:  Medicare; annual deductible has been met by patient.

Services:  99213, 93040

Image transcription text

Mountville Health Plan Medicare Service CPT Usual Charge Allowed Charge Allowed Charge Office/Outpatient
Visit, New, Min. 99201 $54 $48 $43 Office/Outpatient Visit, New, Low 99202 $73 $65 $58 Office/Outpatient Visit,
New, Mod. 99203 $100 $89 $80 Office/Outpatient Visit, New, Mod. 99204 $147 $129 $1 16 Office/Out… Show more

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