21087
CPT/HCPCSImpression and custom preparation of nasal prosthesis
Physician Fee Schedule
Facility
Medicare Payment
$995.13
Submitted Charge$6,030.90
Medicare Allowed$1,278.32
Providers11
Beneficiaries22
Total Services22
Office
Medicare Payment
$903.35
Submitted Charge$2,707.81
Medicare Allowed$1,143.95
Providers10
Beneficiaries42
Total Services43