Why is the MAX6174 output voltage significantly off of its expected voltage?

One common issue that can affect the reference output voltage is the connection of a low value resistance between the TEMP output pin and ground. The TEMP pin is meant to feed into a high impedance resistance such as that of an ADC or op amp. If the pin is not being used, leave it floating or connect a >>10MOhm resistor across it to ground which will limit the source current of the pin to <50nA which is required for proper device operation.