| Item Number | Description | Schedule Fee |
|---|---|---|
| 66734 | TSH quantitation described in item 66716 and 5 tests described in item 66695 (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs 6 or more tests specified on the request form) (Item is subject to rule 6) |
$90.55 |
| Total: | $90.55 | |