Item Number
58121
Description

NOTE: An account issued or a patient assignment form must show the item numbers of the examinations performed under this item Spine—3 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109, if the service to which item 58120 or 58121 applies has not been performed on the same patient within the same calendar year (R)

Medicare Schedule Fee
$126.25
Invoice Total
$126.25