| Item Number | Description | Schedule Fee |
|---|---|---|
| 66723 | Tests described in item 66722, that is, TSH quantitation and 1 test described in 66695, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP - 1 test (Item is subject to rule 6 and 18) |
$37.90 |
| Total: | $37.90 | |