A9502
CPT/HCPCSTechnetium tc-99m tetrofosmin, diagnostic, per study dose
Physician Fee Schedule
Facility
Medicare Payment
$86.52
Submitted Charge$261.69
Medicare Allowed$109.33
Providers4
Beneficiaries27
Total Services72
Office
Medicare Payment
$134.29
Submitted Charge$365.25
Medicare Allowed$168.67
Providers4,089
Beneficiaries248,327
Total Services412,039