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As defined under 410.26(a)(3), general supervision means the service is furnished under the physician's (or other practitioner's) overall direction and control, but the physician's (or other practitioner's) presence is not required during the performance of the service, whereas direct supervision in the office setting means the physician (or other supervising practitioner) must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the service

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The ultrastructural organization of elastic fibers at the interface of the nucleus and annulus of the intervertebral disk

Sabiston DC, Townsend CM