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/I <br /> ;RANGE '-AMILY MEDICAL SRC:;P PA <br /> Jo,:5i93 D,ROCEDURE FEES <br /> -ROCEDURE DESCRIPTION ALT. DESC, DEPT I .O.S. STD. EE <br /> ------------------------------------------------------------------------------------------------------------------------------------ <br /> 2 SURGICAL PATH (COMP.) RL RL 99 85.00 <br /> 36316 PROSTATE SPECIFIC ANTIGEN RL 0 36.00 <br /> 32951 O'SuLLIVAN (INCLUDES GLUCOSE) RL 0 .00 <br /> :39 HEPATITIS PANEL RL RL 99 .00 <br /> 36140 CRP BLOOD WORK RL 0 .00 <br /> 33001 FSH BLOOD RL 1 81.15 <br /> 31-060 jPPER RESP.CULTURE BLOOD WORK RL 1 .00 <br /> 32185 IMMUNEGLOBINS BLOOD WORK RL 1 .00 <br /> =2486 NORTRiPTYt-INE BLOOD WORK RL 1 .00 <br /> 3302 :LH BLOOD WORK RL 0 81.00 <br /> 33150 MAGNESIUM BLOOD WORK RL 1 39.00 <br /> j3825 MERCURY BLOOD WORK RL 1 .00 <br /> :1:6o ACID PHCS. RL 1 .00 <br /> 30:55 MUMPS TITER RL 1 .00 <br /> 35999 ANEMIA PROFILE B BLOOD WORK RL 1 30.80 <br /> :5v:4 HEMATOCRIT BLOOD WORK RL 0 11.00 <br /> 31. 5 GRAM STAIN 87205 RL 0 20.00 <br /> .38A HEMOGLOBIN A-1C RL 99 45.00 <br /> '36262 JALPGRIC ACID RL 1 67.00 <br /> 30178 DNA PROBE (X2) RL 0 .00 <br /> :1705 FECAL FAT iF RL 1 .00 <br /> 31?051 CELL COUNT RL RL 1 35.00 <br /> ':01149 7 BLOOD WORK RL 1 .00 <br /> :7086 URINE CULTURE 87086 RL 5 37.00 <br /> )7:05 UNGAL CULTURE RL 1 .00 <br /> X1231-:(' DRUG SCREEN RL 1 20.00 <br /> )1206 C,ILAMYDiA MICROTRAK BLOODWORK RL 5 38,00 <br /> 30357 T&B LYMPH PROFILE BLOOD WORK RL 0 .00 <br /> .3:A COLLECTION, LAB SPECIMEN RL RL 99 18.00 <br /> ?1132A P,D'ASSIUM RL RL 99 22.25 <br /> ANA ANA RL 5 .00 <br /> :?:50 AMYLASE BLOODWORK RL 5 32.00 <br /> �-OS�40�US BLOOD WORK RL 1 ,00 <br /> -13)3) -'20PHOSYTE S"PP./HELPER PROFILE BLOOD WORK RL 0 154.00 <br /> EC'RULY?ES BLOOD WORK RL 0 23.20 <br /> CRYSTAL ANALYSIS BLOOD WORK RL 1 .00 <br /> -AMIN LAB RL 1 70.50 <br /> : SE�JM CLVCCSE BLOOD WORK RL 1 .00 <br /> - ALKAL:NE MHO. RL 0 31.50 <br /> HIUM -EVEL RL 99 41.00 <br /> �'SF i'ER BLOOD WORK RL 1 95.75 <br /> -ARTI;OL AM RL 99 89.25 <br /> %;a---A RL 1 36.00 <br /> 3�C2 C'117URE SLOODWORK RL 99 60.00 <br /> BLOOD WORK RL 1 .00 <br /> URINE TOX SCREEN DRUG SCR. RL 1 55.00 <br /> _ P<OTIME RL RL 99 28.00 <br /> )0278 HEP B SAG BLOOD ,WOR RL ? .00 <br /> 1Iv TITER BLOOD WORK RL 1 36.00 <br /> =.0=11 VARCELLA 20STER iQG RL 0 10.50 <br /> ;PA ANEMIA PROFI:_E A APA RL 5 27.80 <br /> :21468 NARTRIPTHLINE BLOOD WORK RL 1 .00 <br /> 38302 SURG. PATHOLOGY RL 99 .00 <br />