Q4194

CPT/HCPCS

Novachor, per square centimeter

Physician Fee Schedule

Facility

Medicare Payment

$806.83

Submitted Charge$1,665.47
Medicare Allowed$1,013.53
Providers12
Beneficiaries20
Total Services458
Office

Medicare Payment

$802.93

Submitted Charge$1,718.70
Medicare Allowed$1,007.95
Providers693
Beneficiaries3,417
Total Services77,813.5