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<br /> .RANGE FAMILY MEDICAL GROUP PA
<br /> )6/15/93 PROCEDURE FEES
<br /> ?QOCEDiRE DESCRIPTION ALT. DESC. DEPT I.O.S. STD. FEE
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<br /> .030 XRAY,CHEST, 3 VIEWS,W/INTEEPRET, XR XR 0 96.00
<br /> [["51 XRAY SELLA TURCICA, 2 V W/INTERPRET XR XR 31 .00
<br /> _97 XRAY,CHEST,2 VIEWS, W/INTERPRET. XR XR 31 .00
<br /> 226 XRAY FOREARM, 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 223 XRAY ACROMIOCLAV.JOINTS W/INTERPRET XR XR 31 .00
<br /> 258 XRAY FEMUR W/INTERPRET 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 /> .05 XRAY STERNO-CLA'V.JOINTS,3VIEWS W/INTERPR XR XR 31 .00
<br /> 205 XRAY CERVICAL SPINE, 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 72110 XRAY,L/S SPINE,5 VIEWS W/INTERPRET. XR XR 0 128.00
<br /> 98 XRAY,CHEST,3VIEWS,W/INTERPRET. XR XR 31 .00
<br /> 203 XRAY RIBS,BILAT.W/CHEST PA & INTERPRET XR XR 31 ,00
<br /> 229 XRAY FINGER, 3 V W/INTERPRET XR XR 31 .00
<br /> -45 XRAY SKULL 6 VIEWS W/INTERPRET XR XR 31 .00
<br /> :JO XRAY RIBS,UNILATERAL,3VIEWS W/INTERPRETY XR XR 3i .00
<br /> '2100 XRAY, L/S SPINE, 2 VIEWS W/INTERPRET. XR XR 0 96.00
<br /> 255 TM.MANDIBULAR 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 /> '1120 XRAY,STERUM, 3 VIEWS W/INTERPRET, XR XR 31 .00
<br /> 71.021 CHEST APICAL LGRDOTIC X-RAY XR 1 47.00
<br /> .53 XRAY ZYGOMATIC ARCHES,6V W/FACIAL&INTERP XR XR 31 ,00
<br /> 1010 XRAY,CHEST, 1 VIEW W/INTREPRET, XR XR 0 61.00
<br /> ?.5 PELVIS, 3 VIEWS, W/INTERPRETATION XR XR 31 .00
<br /> .24 XRAY HUMERUS, 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 40 XRAY ANKLE 2 VIEWS W/INTERPRET. XR XR 31 .00
<br /> SO XRAY SELLA TURCICA, 1 VIEW W/INTERPRET XR XR 31 .00
<br /> '09 XRAY, L/S SPINE 2 VIEWS W/INTERPRET XR XR 0 ,00
<br /> XRAY,CHESI,APICAL LGRDOTIC W/INTERPRET. XR XR 31 .00
<br /> '_u70 XRAY, THORASIC SPINE,2 VIEWS W/INTERPRET XR XR 0 77.00
<br /> XRAY ;ACROILIAC JOINTS,4 V,W/INTERPRET XR XR 31 .00
<br /> 2' XRAY WRIST, 3 V W/INTERPRET XR XR 31 .00
<br /> :Ia Y?AY ABDOMEN, 2 V w/INTERPRET XR XR. 31 .00
<br /> _. XRAY PELVIS, STEREO,2 V W/INTERPRET XR XR 31 .00
<br /> - -EST,'VIEW W/ INTERPRETATION XR XR 31 .00
<br /> (RAY KNEE, 2 VIEWS WANTERPRETATION XR XR 31 .00
<br /> ({Al NASAL 30NES 4 V W/INTERPRET XR XR 31 .00
<br /> X;0, SHOULDER, 3 V, W/INTERPRET XR XR 31 .00
<br /> PINE ,5 MEWS W/INTERPRETATION XR XR 31 .00
<br /> t-AV 70ES, W/INTERPRETATION XR XR 31 .00
<br /> CRAY _HCULDER, V, W/INTERPRETATION XR XR 31 .00
<br /> _ (.RAY NAVICULAR W/INTEPRET XR XR 31 .00
<br /> (RAY I.' -CLAV.JOTNTS,3VIEWS WINTER. XR XR 0 71.00
<br /> XRAY POST REDUCTION,2 V W/INTERPRET XR XR 31 .00
<br /> CHEST, 4 'VIEWS W/INTERPRETATION XR XR 31 .00
<br /> 19 XRAY CLAVICLE, 2 V W/INTERPRETATION XR XR 31 .00
<br /> ..8 PRAY HAND, 3 VIEWS W/INTERPET XR XR 31 .00
<br /> 44 XRAY GS CAL CIS, 2 VIEWS W/INTERPRET XR XR 31 .00
<br /> 238 XRAY KNEE 3 VI=r1S W/INTERPRETATION XR XR 31 .00
<br /> 247 XRAY SINUSES, 4 VIEWS W/INTERPRET XR XR 31 .00
<br /> 72.50 XRAY, CERVICAL SPINE,4-5 V W/INTERPRET, XR XR 0 116.00
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