J9217
CPT/HCPCSLeuprolide acetate (for depot suspension), 7.5 mg
Physician Fee Schedule
Facility
Medicare Payment
$132.83
Submitted Charge$1,377.13
Medicare Allowed$167.56
Providers15
Beneficiaries35
Total Services126
Office
Medicare Payment
$132.80
Submitted Charge$1,015.90
Medicare Allowed$169.39
Providers11,985
Beneficiaries93,977
Total Services776,596