| Item Number | Description | Schedule Fee |
|---|---|---|
| 66724 | Tests described in item 66722, if rendered by a receiving APP, other than that described in 66723. It is to include a quantitation of TSH - each test to a maximum of 4 tests described in item 66695 (Item is subject to rule 6 and 18) |
$13.15 |
| Total: | $13.15 | |