90714
CPT/HCPCSDiphtheria and tetanus vaccine (7 years or older)
Physician Fee Schedule
Facility
Medicare Payment
$21.99
Submitted Charge$114.19
Medicare Allowed$28.71
Providers8
Beneficiaries25
Total Services25
Office
Medicare Payment
$20.46
Submitted Charge$61.77
Medicare Allowed$28.68
Providers20,925
Beneficiaries52,238
Total Services52,320