| Item Number | Description | Schedule Fee |
|---|---|---|
| 18372 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of bilateral blepharospasm, in a patient who is at least 12 years of age; including all such injections on any one day (Anaes.) |
$145.65 |
| Total: | $145.65 | |