J1572

CPT/HCPCS

Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg

Physician Fee Schedule

Office

Medicare Payment

$34.64

Submitted Charge$120.43
Medicare Allowed$43.10
Providers24
Beneficiaries17
Total Services5,720