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f <br /> /3 <br /> ORANGE FAMILY MEDICAL GROUP PA <br /> 06/15/93 PROCEDURE FEES PAGE 4 <br /> PROCEDURE DESCRIPTION ALT, DESC. DEPT T.O.S. STD. FEE <br /> ------------------------------------------------------------------------------------------------------------------------------------ <br /> 82565A CREATININE RL RL 99 28.50 <br /> 88155 PAP W/ MATURATION INDEX MATURATION RL 0 36.00 <br /> 88172 BREAST CYTOLOGY RL 1 .00 <br /> 85615 ESR RL 1 26.00 <br /> 8660 F'A BLOOD WORK RL 0 .00 <br /> RPR RPR RL 1 23.00 <br /> 84165 IMMUNOGLOBULIN ELECTRCPHORESIS BLOOD WORK RL 1 .00 <br /> 82365 STONE ANALYSIS RL 1 57.00 <br /> 83545 IRON BINDING CAPACITY BLOOD WORK RL 1 .00 <br /> 87208 STOOL 0 AND P RL 0 62.00 <br /> 87211 WET PREP RL 5 12.00 <br /> 82660 DRUG SCREEN BLOOD WORK RL 1 50.00 <br /> 86403 BETA STREP CULTURE RL 0 65.50 <br /> 81002-GP URINE DIPSTICK RL 1 8.00 <br /> 82009 SERUM KETONES BLOOD WORK RL 1 .00 <br /> 87081 THROAT CULTURE BLOOD WORK RL 1 14.00 <br /> 140A LIPID PROFILE RL RL 99 31.61 <br /> 87117 AFB CULTURE & SMEAR RL 5 65.00 <br /> 83718A CHOLESTEROL, HDL RL RL 99 38.00 <br /> 87;01 SPUTUM FUNGAL CULTURE RL 0 .00 <br /> 147 RHEUM PANEL B RL RL 99 39.00 <br /> 80072 RHEUM PANEL B BLOOD WORK RL 0 37.71 <br /> 84520A BUN (URIC NITROGEN) URIC RL 99 27.75 <br /> 32955 G6PD BLOODWORK RL 99 60.75 <br /> 82310 CALCIUM 82310 RL 0 33.00 <br /> 82524 INSULIN TESTING BLOODWORK RL 99 .00 <br /> 87178 DNA PROBE BLOOD WORK RL 0 38.45 <br /> 82643 DIGOXIN LEVEL BLOOD WORK RL 0 58.00 <br /> 86225 MUMPS TITER BLOOD WORK RL 0 58.50 <br /> 80051 VALPORIC ACID RL 0 68.50 <br /> .41 LIVER PANEL RL RL 99 26.00 <br /> 34295 SODIUM RL 99 .00 <br /> 82540 RL 1 .00 <br /> 85048 WBC BLOOD WORK RL 5 .00 <br /> 86994 C. DEFICILE TOXIN RL 1 .00 <br /> 88108 CYTOLOGY SPUTUM RL 0 .00 <br /> 30061 LIPID PROFILE BLOOD WORK RL 0 40.00 <br /> 86244 A-PHAFETOPROTEIN BLOODWORK RL 1 ,00 <br /> 82465A CHOLESTEROL, TOTAL RL RL 99 28.00 <br /> 80059 HEPATITIS PANEL BLOOD WORK RL 0 .00 <br /> 84180 24 HR. URINE PROTEIN RL 0 .00 <br /> 87207 MALARIA BLOOD WORK RL 1 .00 <br /> 8;002 BRINE DIPSTICK RL 0 8.00 <br /> 84,999 SERUM FRUCTOSAMINE BLOOD WORK RL 1 36.25 <br /> 142 MULTICHEM PANEL 80019 RL 99 29.00 <br /> 87250 VARICELLA ZOSTER CULTURE BLOOD WORK RL 1 .00 <br /> 30009Y LIVER PROFILE BLOOD WORK RL 0 25.18 <br /> 85730 PTT BLOOD WORK RL 1 37.00 <br /> 82251 BILI T&D BLOODWORK RL 99 .00 <br /> 86032 ANTIBODY SCREEN BLOOD WORK RL 0 36.00 <br /> 83020 HEMOGLOBIN ELECT. BLOOD WORK RL 1 .00 <br /> 80082 BLOOD TYPING BLOOD WORK RL 1 .00 <br /> 84045 DILANTIN LEVEL BLOOD WORK RL 0 60.00 <br />