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/6 <br /> ORANGE FAMILY MEDICAL GROUP PA <br /> 06/15/93 PROCEDURE FEES PAGE 7 <br /> PROCEDURE DESCRIPTION ALT. DESC. DEPT T.O.S. STD. FEE <br /> ------------------------------------------------------------------------------------------------------------------------------------ <br /> 'a000 XRAY ABDOMEN 1 VIEW (0) KUB XR 0 76.00 <br /> ':I'0 0AY,Ri3S,81LAT, 6 VIEWS W/IMTREPRET. XR XR 31 80.00 <br /> XRAY STERNUM, 3 VIEWS W/INTERPRET XR XR 31 .00 <br /> BRAY PELV;S 3 LAT HIP, 2 V. W/INT:RP9ET. XR XR 31 .00 <br /> '42 XRAY ;007, 2 VIEWS W/INTERPRET XR XR 31 .00 <br /> zk,4Y CERVICAL SPINE,4-5 V W/INTERPRET XR XR 31 .00 <br /> J2'0 SINUS SERIES XR 0 .00 <br /> :^4 0 XRAY,CERVICAL SPINE, 2 VIEWS W INTERPRET XR XR 0 79.00 <br /> 217 XRAY SACRUM & COCCYX W/INTERPRETATION XR XR 31 .00 <br /> 241 XRAY ANKLE 3 VIEWS/W/INTERPRET. XR XR 31 .00 <br /> 202 XRAY RIBS,BILAT. 6 VIEWS W/INTERPRET XR XR 31 .00 <br /> 4254 'E1P.MANOISULAR JOINT,JNILAT 4 V W/INTER XR XR 31 .00 <br /> )IC XRAY ABDOMEM,2 V W/PA CHEST & INTERPRET XR XR 31 .00 <br /> 212 XRAY,PELVIS AP W/INTERPRETATION XR XR 31 .00 <br /> 248 XRAY FACIAL BONES, 4 V W/INTERPRETATION XR XR 31 .00 <br /> 101 XRAY RIBS,UNILAT.W/PA CHEST & INTERPRET XR XR 31 .00 <br /> 257 XRAY SCOLIOSIS, 1 VIEW XR XR 31 .00 <br /> 236 XRAY ABDOMEN, 3 V W/INTERPRET. XR XR 31 .00 <br /> 21i XRAY SPINE, ENTIRE,AP & LAT W/INTERPRET XR XR 31 .00 <br /> 233 XRAY ABDOMEN, SINGLE AP M/INTERPRET XR XR 31 .00 <br />