Q4262
CPT/HCPCSDual layer impax membrane, per square centimeter
Physician Fee Schedule
Facility
Medicare Payment
$1,013.43
Submitted Charge$1,367.65
Medicare Allowed$1,271.96
Providers54
Beneficiaries94
Total Services12,500
Office
Medicare Payment
$937.75
Submitted Charge$1,273.74
Medicare Allowed$1,176.97
Providers939
Beneficiaries5,009
Total Services1,185,273.8