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2 <br /> ORANGE FAMILY MEDICAL GROUP PA <br /> )6/15/93 PROCEDURE FEES <br /> OROCEDURE DESCRIPTION ALT. DESC. DEPT T.O.S, STD. FEE <br /> ------------------------------------------------------------------------------------------------------------------------------------ <br /> 32746 FOLATE BLOOD WORK RL 0 67.75 <br /> 80099 UNLISTED PANEL BLOODWORK RL 5 .00 <br /> 94155 PROTEIN BLOODWORK RL 5 �0 <br /> 82310 STONE ANAYLIS BLOOD WORK RL 1 43.75 <br /> ?2575 CREATININE CLEARANCE BLOOD WORK RL 0 41.75 <br /> :4103 PREG. SERIUM RL RL 1 19.00 <br /> :07831 QUINIDINE QUANT. BLOOD WORK RL 1 .00 <br /> ;3690 LIPASE BLOOD WORK RL 1 .0D <br /> .196925 ID PANEL IV BLOOD WORK RL 0 154.00 <br /> APB ANEMIA PROFILE B PROFILE RL 5 84.50 <br /> 94403 TESTERONE BLOOD WORK RL 1 .00 <br /> 145 PRENATAL PANEL RL RL 99 37.00 <br /> 82552 CPK ISOENZYME BLOOD WORK RL 1 .00 <br /> 35025 CBC & DIFF BLOODWORK RL 0 ,00 <br /> 80009 LIVER PANEL RL 0 25.18 <br /> 36291 ANTI-148S BLOOD WORK RL 1 60.00 <br /> 20073A RENAL PANEL RL RL 99 24,05 <br /> 87252 VIRAL CULTURE RL 1 39.00 <br /> 83655 LEAD BLOOD WORK RL 1 32.85 <br /> 38304 SURGICAL PATH - SKIN,CYST,TAG/DEBRID. SURG. PATH RL 0 40.00 <br /> 87178(X2) DNA PROBE GC/CHLAMYDIA RL 99 38.45 <br /> 81000 URINALSIS, COMPLETE LAB WORK RL 0 14.00 <br /> 82768 FOLATE BLOOD WORK RL 0 .00 <br /> ;HELPER P T-LYMPHOSYTE SUPP./HELPER PROFILE BLOOD WORK RL 0 154.00 <br /> 82570 24 HR. URINE CREAT. RL 0 .00 <br /> 33053 HEMOGLOBIN S (SICKLE CELL) BLOODWORK RL 1 36.00 <br /> 87230 C. DIFF. TOXIN BLOOD WORK RL 1 90.75 <br /> 58150 PAP SMEAR RL 0 28.00 <br /> 34146 PROLACTIN BLOOD WORK RL 0 93.25 <br /> :50 STOOL CULTURE RL RL 99 60.00 <br /> 84999 UNLISTED CHEMISTRY OR TOXI PROC. BLOODWORK RL 5 .00 <br /> ;6593 VDRL, SPINAL FLUID BLOODWORK RL 5 39.50 <br /> 9105 SPUTUM CYTOLOGY RL 0 .00 <br /> '4443 TSH BLOODWORK RL 5 .00 <br /> --3 PAP SMEAR RL RL 99 28.00 <br /> :53 74EOPH LEVEL RL RL 99 59.00 <br /> CE-A RL 0 68.50 <br /> 9 ANEMIA PROFILE A RL RL 99 35.00 <br /> :;-'8A TP:GL'CERIDES RL RL 99 31.75 <br /> :_303 FRACTIONATED CATECHOLANINES BLOOD WORK RL 1 .00 <br /> :63 3'30L, CULTURE 87163 RL 0 63.00 <br /> :_=4 :;M -_VELS RL 0 .00 <br /> THYROID PANEL WiTSH BLOOD WORK RL 0 40.68 <br /> 3 LEC'RGLY'�S RL 1 .00 <br /> CHLORIDE RL 99 .00 <br /> .37 GLUCOSE RL RL 99 23.00 <br /> 2 060 -HANOL BLOOD WORK RL 1 .00 <br /> 84030 ?KU RL 0 18.00 <br /> 36080 3LOOD TYPE BLOOD WORK RL 1 .00 <br /> 80085 ANEMIA PROFILE BLOOD WORK RL 0 30.80 <br /> 041180 URINE BLOOD BLOOD WORK RL 1 58.75 <br /> 44231 DRUG SCREEN RL 1 34,00 <br /> 134 DIGOXIN LEVEL RL RL 99 51.00 <br />