A9596
CPT/HCPCSGallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
Physician Fee Schedule
Facility
Medicare Payment
$230.31
Submitted Charge$423.01
Medicare Allowed$289.06
Providers5
Beneficiaries11
Total Services16
Office
Medicare Payment
$813.32
Submitted Charge$2,196.40
Medicare Allowed$1,020.83
Providers630
Beneficiaries7,292
Total Services39,855.2