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<br /> ORANGE FAMILY MEDICAL GROUP PA
<br /> 06/15/93 PROCEDURE FEES PAGE 6
<br /> PROCEDURE DESCRIPTION ALT, DESC. DEPT T.O.S. STD. FEE
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<br /> :030 XRAY,CHEST, 3 VIEWS,W/INTREPRET. XR XR 0 96.00
<br /> 251 XRAY SELLA TURCICA, 2 V W/INTERPRET XR XR 31 .00
<br /> ;9) XRAY,CHEST,2 VIEWS, W/INTERPRET. XR XR 31 .00
<br /> 2.6 XRAY FOREARM, 2
<br /> VIEWS WiINTERPRET XR XR 31 .00
<br /> 243 XRAY ACROMI13CLAV.o3INTS w/INTERPRET XR XR 31 .00
<br /> 258 XRAY FEMUR W/!NTERPRET XR XR 31 .00
<br /> 239 XRAY TIBIA&FIBULA W/INTERPRETATION XR XR 31 .00
<br /> 220 XRAY SCAPULA, 3 V W/INTERPRETATION XR XR 31 .00
<br /> 205 XRAY 571ERNO-CLAV.JOINTS,3VIEWS W/INTERPR XR XR 31 .00
<br /> 206 XRAY CERVICAL SPINE, 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 727110 XRAY,L/S SPINE,5 VIEWS W/INTERPRET. XR XR 0 128.00
<br /> 198 XRAY,CHEST,3VIEWS,W/INTERPRET. XR XR 31 .00
<br /> 203 XRAY RIBS,SILAT.W/CHEST PA & INTERPRET XR XR 31 .00
<br /> 229 XRAY FINGER, 3 V W/INTERPRET XR XR 31 .00
<br /> 245 XRAY SKULL 6 VIEWS W/INTERPRET XR XR 31 .00
<br /> 200 XRAY RIBS,UNILATERAL,3VIEWS W/INTERPRETY XR XR 31 .00
<br /> 72100 XRAY, L/S SPINE, 2 VIEWS W/INTERPRET. XR XR 0 96.00
<br /> 255 TEM.MANOIBULAR JOINT,BILAT.6 V WINTER. XR XR 31 .00
<br /> 246 XRAY SKULL, 4 VIEWS W/INTERPRET XR XR 31 .00
<br /> 243 XRAY FOOT 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 256 XRAY NECK SOFT TISSUE 2 V W/INTERPRET XR XR 31 .00
<br /> 71120 XRAY,STERUM, 3 VIEWS W/INTERPRET. XR XR 31 .00
<br /> 71021 CHEST APICAL LORDOTIC X-RAY XR 1 47.00
<br /> =53 XRAY ZYGONATIC ARCHES,6V W/FACIAL&INTERP XR XR 31 .00
<br /> 71010 XRAY,CHEST, 1 VIEW W/INTREPRET, XR XR 0 61,00
<br /> 215 PELVIS, 3 VIEWS, W/INTERPRETATION XR XR 31 .00
<br /> 224 XRAY HUMERUS, 2 VIEWS W/INTERPRET XR XR 31 A
<br /> 240 XRAY ANKLE 2 VIEWS W/INTERPRET. XR XR 31 .00
<br /> 250 XRAY SELLA TURCICA, 1 VIEW W/INTERPRET XR XR 31 .00
<br /> 209 XRAY, L/S SPINE 2 VIEWS W/INTERPRET XR XR 0 .00
<br /> :96 XRAY,CHEST,APiCAL LORDOTIC W/INTERPRET. XR XR 31 .00
<br /> ':070 XRAY, THORASIC SPINE,2 VIEWS W/INTERPRET XR XR 0 77.00
<br /> .o XRAY SACROILIAC JOINTS,4 V,W/INTERPRET XR XR 31 .00
<br /> 221 XRAY WRIST, 3 V W/INTERPRET XR XR 31 .00
<br /> XRAY ABDOMEN, 2 V W/INTERPRET XR XR 31 .00
<br /> 13 XRAY PELVIS, STERE0,1 V WiINTERPRET XR XR 31 .00
<br /> 5 XRAY,C4EST,IVIEW W/ INTERPRETATION XR XR 31 .00
<br /> 31 XRAY KNEE, 2 VIEWS W/INTERPRETATION XR XR 31 .00
<br /> 2�9 XRAY NASAL BONES 4 V U/INTERPRET XR XR 31 .00
<br /> 22 XRAY, SHOULDER, 3 V, VANTERPRET XR XR 31 .00
<br /> :10 L/S SPINE ,5 VIEWS VINTERPRETATION XR XR 31 .00
<br /> 2�9 XRAY TOES, W/INTERPRETATION XR XR 31 .00
<br /> -11 XRAY SHOULDER, 2 V, W/INTERPRETATION XR XR 31 .00
<br /> 234 XRAY NAVICULAR W/INTEPRET XR XR 31 .00
<br /> :130 XRAY STERNO-CLAV.JOINTS,3VIEWS W/INTER. XR XR 0 71.00
<br /> 231 XRAY POST REDUCTION,1 V W/INTERPRET XR XR 31 .00
<br /> 199 CHEST, 4 VIEWS W/INTERPRETATION XR XR 31 .00
<br /> 219 XRAY CLAVICLE, 2 V W/INTERPRETATION XR XR 31 .00
<br /> 2418 XRAY HAND, 3 VIEWS W/INTERPET XR XR 31 .00
<br /> 244 XRAY OS CALCIS, 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 238 XRAY KNEE 3 VIEWS W/INTERPRETATION XR XR 31 .00
<br /> 247 XRAY SINUSES, 4 VIEWS W/INTERPRET XR XR 31 .00
<br /> 72050 XRAY, CERVICAL SPINE,4-5 V W/INTERPRET. XR XR 0 116.00.
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