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Outpatient Ratio of Cost to Charges Effective 09/01/2022 TPINPI365048301 422236601 282322101 127298107 364187001 414962701 208013701 286326801 158977201 365612601 387515501 282268601 094215302 130089906
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Form cost of outpatient is a document that includes all costs associated with outpatient medical services.
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The purpose of form cost of outpatient is to track and report the costs associated with outpatient medical services accurately.
Information such as service costs, date of service, patient information, and healthcare provider details must be reported on form cost of outpatient.
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