J1097

CPT/HCPCS

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Physician Fee Schedule

Facility

Medicare Payment

$76.05

Submitted Charge$301.66
Medicare Allowed$95.35
Providers528
Beneficiaries131,001
Total Services855,098
Office

Medicare Payment

$88.30

Submitted Charge$314.61
Medicare Allowed$110.83
Providers6
Beneficiaries11
Total Services33