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/U <br /> ORANGE FAMILY MEDICAL GROUP PA <br /> 06/15/93 PROCEDURE FEES PAGE 1 <br /> PROCEDURE DESCRIPTION ALT. DESC. DEPT T.O.S. STD, FEE <br /> ------------------------------------------------------------------------------------------------------------------------------------ <br /> 82954(X4) GTT OL 1 25.00 <br /> 829 O'S�JLL:VAN OL OL 1 .00 <br /> 36406 VENIPUNCTURE, UNCER AGE 3, OTHER VEIN 36406 OL 0 35.00 <br /> Zia *ET MOUNT/KOH OL OL 1 12.00 <br /> 111 URINALYSIS OL OL 5 14,00 <br /> 172 URINE )IPSTICK OL OL 1 1,00 <br /> 167 MONOSPOT OL OL 1 25.00 <br /> 35651 SED ;ATE B_OOD WORK OL 0 15.00 <br /> 164 GRAM STAIN OL OL 20.00 <br /> 161 FINGERSTICK BS 82948 OL 5 11.00 <br /> 99000 HAND. SPECIMEN TRANSFER(OFFICE TO LAS) OL 0 10.00 <br /> 80073 RENAL PROFILE OL OL i 29.00 <br /> 162 GTT 3 HR 6 HR OL OL i 45.00 <br /> 83118 HDL CHOLESTEROL STUDY HDL OL 5 21.00 <br /> 155 URINE CULTURE 87086 OL 1 35.00 <br /> 82952(X2) GTT OL 1 20.00 <br /> 140 LIPID PROFILE OL OL 1 27.00 <br /> 82948 GLUCOSE, FINGERSTICK 52948 OL 5 11.00 <br /> 94520 BUN (URIC NITROGEN) URIC OL 1 18.00 <br /> 168 ENZYNE IMMONOASSAY FOR INFECT AG OL OL 0 16.00 <br /> 86317 IMMUNOASSAY-INFEC. AGENT ANTIGEN RAPID STRE OL 5 19.00 <br /> 36600 ARTERIAL PUNCTURE OL 0 55.00 <br /> 82565 CREATINIE OL 5 18.00 <br /> 34132 POTASSIUM OL OL 1 21.00 <br /> 80019 MULTICHEM PANEL 80019 OL 5 29.00 <br /> 131 3LOOD COL:ECTION-IN HOUSE BLOOD-IN OL 1 3.00 <br /> 166 HEMOCCULT X1 X 3 OL OL 1 3.50 <br /> 165 nEMA"OCRiT 93040 OL 5 11.00 <br /> x7220 KOH PREP OL 5 12.00 <br /> PEAK F±ON PEAK FLOP 4l 0 18.00 <br /> :o HEMOGLOBIN A-1C OL OL 5 18.00 <br /> ?` GC CJLTLRE OL OL 1 20.00 <br /> :00 EKG WITH INTERPRETATION OL OL 1 45.00 <br /> ;56:0 PROTnOMBIN TIME BLOOD WORK OL 1 30.00 <br /> 44 POTASSIUM OL OL 5 14.00 <br /> 'C THROAT CULTURE OL OL 5 12.00 <br /> 59 SED RATE OL OL 1 15.00 <br /> <6410 VESIPUNCT,,RE,NEEDIN6 0 SKILL OL 0 35.00 <br /> :73 URINE PREGNANCY TEST OL OL 1 16.00 <br /> ?: 36 HEMOGLOBIN, GLYCOSYLATED ALC OL 0 31.00 <br /> �41178 TRIGLYCERIDES OL OL 5 19.00 <br /> ::415 VENIPUNCTURE, ROUTINE OL 5 3.00 <br /> 32465 TOTAL CHOLESTEROL OL OL 5 19.00 <br /> 151 DERMOPATH RL RL 99 45.00 <br /> 38305 SURGICAL PATH SURD. PATH RL 0 85.00 <br /> )06049 BLOOD TYPE BLOOD WORK RL 1 .00 <br /> 86006 HEP S S BLOOD WORK RL 1 .00 <br /> 85044 RETIC COUNT RL 0 .00 <br /> 92662 TEGRETOL BLOOD WORK RL 1 62.50 <br /> 82952 GLUCOSE TOLERANCE TEST GTT RL 1 48.00 <br /> 86592 VDRL, SERUM BLOODWORK RL 5 33.00' <br /> 133 CULTURE/SENSITIVITY RL RL 99. 35.00 <br /> 88160 BREAST SECRETIONS BLOOD WORK RL 1 .00 <br />