Q4197
CPT/HCPCSPuraply xt, per square centimeter
Physician Fee Schedule
Facility
Medicare Payment
$123.33
Submitted Charge$438.46
Medicare Allowed$154.83
Providers22
Beneficiaries43
Total Services2,553
Office
Medicare Payment
$127.89
Submitted Charge$408.05
Medicare Allowed$160.57
Providers1,412
Beneficiaries4,470
Total Services417,766.4