90954
CPT/HCPCSDialysis services, 4 or more physician visits per month (2-11 years)
Physician Fee Schedule
Facility
Medicare Payment
$765.72
Submitted Charge$3,302.20
Medicare Allowed$964.83
Providers54
Beneficiaries63
Total Services330
Office
Medicare Payment
$788.68
Submitted Charge$3,703.43
Medicare Allowed$993.56
Providers17
Beneficiaries14
Total Services68