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, <br /> �v <br /> ORANGE FAMILY MEDICAL GROUP PA <br /> :6/15x'93 PROCEDURE FEES <br /> PROCEDURE DESCRIPTION ALT. DESC. DEPT T.O.S. STD. FEE <br /> ------------------------------------------------------------------------------------------------------------------------------------ <br /> 82954{X4) GTT OL 1 25.00 <br /> 829 O'SULLiVAN OL OL 1 .00 <br /> 36406 VENIPUNCTURE, UNDER AGE 3, OTHER VEIN 36406 OL 0 35.00 <br /> 174 NET MOLNT/KOH OL OL 1 12.00 <br /> ill URINALYSIS OL OL 5 14.00 <br /> 172 URINE DIPSTICK OL OL 1 8.00 <br /> 167 MONOSPOT OL OL 1 25.00 <br /> 35651 SED RATE BLOOD WORK OL 0 15.00 <br /> 164 GRAM STAIN OL OL 1 20.00 <br /> 161 FINGERSTICK BS 82948 OL 5 11.00 <br /> 99000 HAND. SPECIMEN TRANSFER(OFFICE TO LAB) OL 0 10.00 <br /> 80073 RENAL PROFILE OL OL i 29.00 <br /> 162 GTT 3 HR 6 HR OL OL 1 45.00 <br /> 83718 HDL CHOLESTEROL STUDY HOL 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 /> 32948 GLUCOSE, FINGERSTICK 52948 OL 5 11.00 <br /> 94520 BUN (URIC NITROGEN) URIC OL 1 18.00 <br /> 168 ENZYME IMMUNOASSAY 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 /> 84132 POTASSIUM OL OL 1 21.00 <br /> 80019 MULTICHEM PANEL 80019 OL 5 29.00 <br /> 131 3LOOD COLLECTION-IN HOUSE BLOOD-IN OL 1 3.00 <br /> 166 HEMOCCULT Xl X 3 OL OL 1 3.50 <br /> 165 HEMA70CRIT 93040 OL 5 11.00 <br /> 51220 KOH PREP OL 5 12.00 <br /> '.76 PEAK F,-OW PEAK FLOW OL 0 18.00 <br /> .;o HEMOGLOBIN A-1C OL OL 5 18.00 <br /> %5 GC CJLTGRE OL OL 1 20.00 <br /> `U ECG WITH INTERPRETATION OL OL 1 45.00 <br /> PR IN TiME BLOOD WORK OL 1 30.00 <br /> .44 POTASSIUM OL OL 5 14.00 <br /> "0 'HROAT CUL'URE OL OL 5 12.00 <br /> :9 SED RATE OL OL 1 15.00 <br /> :0 10 4ENI'')UNCT'-RE,NEEDING ND SKILL OL 0 35.00 <br /> TRINE PREGNANCY TEST OL OL 1 16.00 <br /> GLYCOSYLATED ALC OL 0 31.00 <br /> :41=118 'RiGLYCERIDES OL OL 5 19.00 <br /> IENIP�'X j URE, ROUTINE OL 5 3.00 <br /> 46; 737 AL CXLESTEROL OL OL 5 19.00 <br /> DERMOPA'H RL RL 99 45.00 <br /> 8?O5 SURGICAL PATH SUR6. PATH RL 0 85.00 <br /> -06 49 BLOOD T'�PE BLOOD WORK RL 1 .00 <br /> 36006 HEP 8 S BLOOD WORK RL 1 .00 <br /> 35044 RETIC COUNT RL 0 .00 <br /> 32662 TEGRETOL BLOOD WORK RL 1 62.50 <br /> 82952 GLUCOSE TOLERANCE 'EST GTT RL 1 48.00 <br /> 86592 VDRL, SERUM Bl00DWORK RL 5 33.00 <br /> 133 CULTURE/SENSITIVITY RL RL 99 35.00 <br /> 38160 BREAST SECRETIONS BLOOD WORK RL 1 .00 <br />