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Review Question - QID 210118

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QID 210118 (Type "210118" in App Search)
A 60-year-old female presents to your office for evaluation of 6 months of back pain. She was referred to you by her primary care physician and presents with a consultation request in hand. You note she was last seen by your partner for hip pain 4 years ago but has not returned to the office since. You perform a detailed history (level 3), comprehensive examination (level 4), and low complexity medical decision making (level 3). You dictate an office note and mail a letter to the referring primary care physician regarding your findings. This encounter should be billed as which of the following?