HomeMy WebLinkAboutAgenda - 06-29-1993 - III-O 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
Action Agenda
Item No. Q
ACTION AGENDA ITEM ABSTRACT
Meeting Date: JUNE 29, 1993
SUBJECT: CONTRACT RENEWAL; JAIL MEDICAL
DEPARTMENT: PURCHASING & CENTRAL SRVS. PUBLIC HEARING YES: NO: XX
ATTACHMENT(S) : INFORMATION CONTACT: SHERIFF OR
PURCHASING DIRECTOR
Renewal Telephone Number-
Fee Schedule Hillsborough -732-8181
Chapel Hill -967-9251
Mebane -227-2031
Durham -688-7331
PURPOSE: To consider renewing a contract with the Orange Family
Medical Group for Jail Medical Services through June 30, 1994.
BACKGROUND: Since 1985 the Orange Family Medical Center has provided
medical services to the inmates of the Orange County Jail. We
are mandated by State law to provide the medical care. In 1988,
ownership of the Medical Group was changed and the name of the
facility changed to the Orange Family Medical Group.
Orange Family Medical Group will renew for the period of July 1, 1993
through June 30, 1994 for $15, 000. This represents a 13 . 6% increase
over the past year, however, remains less expensive than other options
we have explored. During the next year, we will be exploring ways in
which part of this contract may be fulfilled with current County staff
in order to contain future cost increases.
The County is invoiced separately for testing and x-rays required as
treatment of the inmate. A schedule of these fees is attached for your
reference. Costs for this category of service have traditionally been
approximately $2 , 000-$3 , 000 per year.
RECOMMENDATION: The Manager recommends approval of a contract with
Orange Family Medical Group, P.A. through June 30, 1994 for a sum of
$15, 000 per year; and authorize the Chair to sign on behalf of the
Board.
2
RENEWAL AGREEMENT BETWEEN
COUNTY OF ORANGE
AND
ORANGE FAMILY MEDICAL GROUP, P.A.
NORTH CAROLINA
COUNTY OF ORANGE
WHEREAS, an agreement was made and entered into as of the
1st day of July, 1989 by and between Orange County,
hereinafter referred to as the "County" and Orange Family
Medical Group, P.A. , hereinafter referred to as "Medical
Group", for the provision of primary medical services for the
Orange County Jail.
WHEREAS, the COUNTY and the MEDICAL GROUP mutually agree to
the following:
1. The agreement will be continued for the period
beginning July 1, 1993 and ending at 12 : 00
midnight on June 30, 1994.
2 . Section E, 1(a) shall read "Fifteen thousand
dollars per annum to be paid in equal monthly
installments of $1,250 each. This compensation
is for all services described in this agreement
performed by the Medical Group during the
normal business hours including the sick calls
and other visits to the jail, the office of the
Medical Group or such other health care
facility selected by the attending physician
pursuant to Section A of this agreement. "
3 . All other terms and conditions remain the same.
FOR AND ON BEHALF OF
COUNTY OF ORANGE
DATE:
MOSES CAREY, JR. , CHAIR
FOR AND ON BEHALF OF
ORANGE FAMILY MEDICAL GROUP, P.A.
DATE:
DR. ARTHUR AXELBANK, PRESIDENT
DATE
IT
RENEWAL AGREEMENT BETWEEN
COUNTY OF ORANGE
AND
ORANGE FAMILY MEDICAL GROUP, P.A.
NORTH CAROLINA
COUNTY OF ORANGE
WHEREAS, an agreement was made and entered into as of the
1st day of July, 1989 by and between Orange County,
hereinafter referred to as the "County" and Orange Family
Medical Group, P.A. , hereinafter referred to as "Medical
Group" , for the provision of primary medical services for the
Orange County Jail.
WHEREAS, the COUNTY and the MEDICAL GROUP mutually agree to
the following:
1. The agreement will be continued for the period
beginning July 1, 1993 and ending at 12 : 00
midnight on June 30, 1994.
2 . Section E, 1(a) shall read "Fifteen thousand
dollars per annum to be paid in equal monthly
installments of $1, 250 each. This compensation
is for all services described in this agreement
performed by the Medical Group during the
normal business hours including the sick calls
and other visits to the jail, the office of the
Medical Group or such other health care
facility selected by the attending physician
pursuant to Section A of this agreement. "
3 . All other terms and conditions remain the same.
FOR AND ON BEHALF OF
COUNTY OF ORANGE
DATE: //93
MO ES CAREY, JR. , CHAIR
FOR AND ON BEHALF OF
ORANGE FAMILY MEDICAL GROUP, P.A.
DATE: 27,(///;-43
DR. ARTHUR AXELB K, PRESIDENT
This instrument has been preaudited in the manner required by
the Local Government Budget and Fiscal Control Act.
KENNETH T. CHAVIOUS, FINANCE DIRECTOR
3
This instrument has been preaudited in the manner required by
the Local Government Budget and Fiscal Control Act.
KENNETH T. CHAVIOUS, FINANCE DIRECTOR
4
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 PROCEDURE FEES PAGE 1
PROCEDURE DESCRIPTION ALT, DESC, DEPT T.O.S. STD, `EE
82954(X4) GTT OL 1 25,00
829 O'SULLV,N OL OL 1 ,00
3646 VENIPUNCTURE, UNDER AGE 3, OTHER VEIN 36406 OL 0 35,00
17, WET MOUNT/KOH OL UL 1 12.00
171 URI'NALYSI'S OL OL 5 14,00
172 URINE DIPSTICK OL UL 1 8,00
167 MONOSPOT OL OL 1 25,00
85651 SED RATE BLOOD WORK OL 0 15.00
164 GRAM STAIN OL OL 1 20.00
161 FINGERSTICK BS 82948 OL 5 11,00
99000 HAND, SPECIMEN TRANSFER(OFFICE TO LAB) OL 0 10.00
80073 RENAL PROFILE OL OL 1 29.00
162 GTT 3 HR 6 HR OL OL 1 45.00
83718 HDL CHOLESTEROL STUDY HDL OL 5 21.00
155 URINE CULTURE 87086 OL 1 35.00
82952(X2) GTT OL 1 20.00
140 LIPID PROFILE OL OL 1 27.00
82948 GLUCOSE, FINGERSTICK 82948 OL 5 11.00
84520 BUN (URIC NITROGEN) URIC OL 1 18,00
168 ENZYME IMMONOASSAY FOR INFECT AG OL OL 0 16.00
86317 IMMUNOASSAY-INFEC. AGENT ANTIGEN RAPID STRE OL 5 19.00
36600 ARTERIAL PUNCTURE OL 0 55.00
82565 CREATINIE OL 5 18.00
84132 POTASSIUM OL OL 1 21.00
80019 MULTICHEM PANEL 80019 OL 5 29.00
131 BLOOD COLLECTION-IN HOUSE BLOOD-IN OL 1 3,00
166 HEMOCCULT X1 X 3 OL OL 1 3.50
165 HEMATOCRIT 93040 OL 5 11,00
37220 KOH PREP OL 5 12.00
176 PEAK FLOW PEAK FLOW OL 0 18.00
138 HEMOGLOBIN A-1C OL OL 5 18,00
175 GC CULTURE OL OL 1 20,00
160 EKG WITH INTERPRETATION OL OL 1 45,00
85610 PROTHOMBIN TIME BLOOD WORK OL 1 30,00
.44 POTASSIUM OL OL 5 14.00
170 THROAT CULTURE OL OL 5 12.00
169 SED RATE OL OL 1 15.00
36410 VENIPUNCTURE,NEEDING MD SKILL OL 0 35.00
173 URINE PREGNANCY TEST OL OL 1 16.00
83036 HEMOGLOBIN, GLYCOSYLATED ALC OL 0 31,00
34478 TRIGLYCERIDES OL OL 5 19,00
36415 VENIPUNCTURE, ROUTINE OL 5 3.00
82465 TOTAL CHOLESTEROL 0L OL 5 19.00
151 DERMOPATH RL RL 99 45.00
38305 SURGICAL PATH SURG. PATH RL 0 85.00
006049 BLOOD TYPE BLOOD WORK RL 1 .00
86006 HEP B S BLOOD WORK RL 1 .00
85044 RETIC COUNT RL 0 .00
82662 TEGRETOL ' BLOOD WORK RL 1 62.50
82952 GLUCOSE TOLERANCE TEST GTT RL 1 48.00
86592 VDRL, SERUM BL00DWORK RL 5 33,00
133 CULTURE/SENSITIVITY RL RL 99 35.00
88160 BREAST SECRETIONS BLOOD WORK RL 1 .00
5
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 PROCEDURE FEES PAGE 2
°JCEDURE DESCRIPTION ALT, DESC, DEPT T.O.S. STD, FEE ,
152 SURGICAL PATH (COMP.) RL RL 99 85,00
86316 PROSTATE SFECIriC ANTIGEN RL 0 36.00
82951 O'SULLIVAN (INCLUDES GLUCOSE) RL 0 ,00
1:9 HEPATITIS PANEL RL RL 99 .00
86140 CRP BLOOD WORK RL 0 ,00
83001 FSH BLOOD RL 1 81.75
37060 UPPER RESP,CULTURE BLOOD WORK RL 1 .00
82785 IMMUNEGLOBINS BLOOD WORK RL 1 .00
82486 NORTRIPTYLINE BLOOD WORK RL 1 .00
83002 LH BLOOD WORK RL 0 81.00
83750 MAGNESIUM BLOOD WORK RL 1 39,00
83825 MERCURY BLOOD WORK RL 1 .00
84066 ACID PHOS, RL 1 .00
86255 MUMPS TITER RL 1 .00
85999 ANEMIA PROFILE B BLOOD WORK RL 1 30.80
85014 HEMATOCRIT BLOOD WORK RL 0 11.00
87205 GRAM STAIN 87205 RL 0 20.00
138A HEMOGLOBIN A-1C RL 99 45.00
86262 VALPORIC ACID RL 1 67.00
80178 DNA PROBE (X2) RL 0 .00
82705 FECAL FAT RL 1 ,00
89051 CELL COUNT RL RL 1 35,00
001149 T4 BLOOD WORK RL 1 .00
87086 URINE CULTURE 87086 RL 5 37.00
87106 FUNGAL CULTURE RL 1 ,00
84231-GP DRUG SCREEN RL 1 20.00
87206 CHLAMYDIA MICROTRAK BL00DWORK RL 5 38.00
86357 T&B LYMPH PROFILE BLOOD WORK RL 0 .00
131A . COLLECTION, LAB SPECIMEN RL RL 99 18.00
84132A POTASSIUM RL RL 99 22.25
86256 ANA ANA RL 5 .00
82150 AMYLASE BL00DWORK RL 5 32.00
84100 PHOSPHORUS BLOOD WORK RL 1 .00
88180(13) T-LYMPHOSYTE SUPP./HELPER PROFILE BLOOD WORK RL 0 154.00
80004 ELECTROLYTES BLOOD WORK RL 0 23.20
89060 CRYSTAL ANALYSIS BLOOD WORK RL 1 .00
32607 312 VITAMIN LAB RL 1 70,50
82947 SERUM GLUCOSE BLOOD WORK RL 1 .00
84075 ALKALINE PHO. RL 0 31.50
83725 LITHIUM LEVEL RL 99 41.00
85256 RMSF TITER BLOOD WORK RL 1 95.75
82533 CARTISOL AM RL 99 89.25
86228 RUBELLA RL 1 36.00
87040 BLOOD CULTURE BL00DWORK RL 99 60.00
82250 TOTAL BILI. BLOOD WORK RL 1 .00
799007 URINE TOX SCREEN DRUG SCR, RL 1 55.00
146 PROTIME RL RL 99 28.00
86278 HEP 8 SAG BLOOD ,WOR RL 1 .00
86312 HIV TITER BLOOD WORK RL 1 36.00
86517 VARCELLA ZOSTER IQG RL 0 70.50
APA ANEMIA PROFILE A APA RL 5 27.80
82468 NARTRIPTYLINE BLOOD WORK RL 1 .00
88302 SURG, PATHOLOGY RL 99 .00
6
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 PROCEDURE FEES PAGE 3
PROCEDURE DESCRIPTION ALT, DESC. DEPT T,O,S. STD. FEE
32746 FOLATE BLOOD WCRK RL 0 67,75
80099 UNLISTED PANEL BLOODwORK RL 5 .00
84155 PROTEIN BLOODWORK RL 5
82370 STONE ANAYLIS CLOUD WORK RL 1 43,75
82575 CREATTNINE CLEARANCE BLOOD WORK RL 0 41.75
84703 PREG. SERIUM RL RL 1 19.00
007831 QUINIDINE QUANT. BLOOD WORK RL 1 .00
83690 LIPASE BLOOD WORK RL 1 .00
096925 ID PANEL IV BLOOD WORK RL 0 154,00
APB ANEMIA PROFILE B PROFILE RL 5 84,50
84403 TESTERONE BLOOD WORK RL 1 .00
145 PRENATAL PANEL RL RL 99 37,00
82552 CPK ISOENZYME BLOOD WORK RL 1 .00
85025 CBC & DIFF BLOODWORK RL 0 .00
80009 LIVER PANEL RL 0 25.18
86291 ANTI-HBS BLOOD WORK RL 1 60.00
80073A RENAL PANEL RL RL 99 24.05
87252 VIRAL CULTURE RL 1 39.00
83655 LEAD BLOOD WORK RL 1 32.85
88304 SURGICAL PATH - SKIN,CYST,TAG/DEBRID, SURG, PATH RL 0 40.00
87178(X2) DNA PROBE GC/CHLAMYDIA RL 99 38.45
81000 URINALSIS, COMPLETE LAB WORK RL 0 14,00 •
82768 FOLATE BLOOD WORK RL 0 .00
/HELPER P T-LYMPHOSYTE SUPP./HELPER PROFILE BLOOD WORK RL 0 154.00
82570 24 HR, URINE CREAT. RL 0 .00
83053 HEMOGLOBIN S (SICKLE CELL) BLOODWORK RL 1 36.00
87230 C. RIFF. TOXIN BLOOD WORK RL 1 90.75
88150 PAP SMEAR RL 0 28.00
84146 PROLACTIN BLOOD WORK RL 0 93.25
150 STOOL CULTURE RL RL 99 60.00
84999 UNLISTED CHEMISTRY OR TOXI PROC. BLOODWORK RL 5 ,00
86593 VDRL, SPINAL FLUID BLOODWORK RL 5 39.50
88105 SPUTUM CYTOLOGY RL 0 .00
84443 TSH BLOODWORK RL 5 .00
143 PAP SMEAR RL RL 99 28.00
153 THEOPH LEVEL RL RL 99 59,00
86151 CEA RL 0 68.50
149 ANEMIA PROFILE A RL RL 99 35.00
84478A TRIGLYCERIDES RL RL 99 31,75
82383 FRACTIONATED CATECHOLAMINES BLOOD WORK RL 1 .00
87163 STOOL, CULTURE 87163 RL 0 63.00
82784 IGM LEVELS RL 0 .00
84479 THYROID PANEL W/TSH BLOOD WORK RL 0 40.68
80003 ELECTROLYTES RL 1 .00
82435 CHLORIDE RL 99 .00
137 GLUCOSE RL RL 99 23,00
82060 ETHANOL BLOOD WORK RL 1 ,00
84030 PKU RL 0 18.00
86080 BLOOD TYPE BLOOD WORK RL 1 .00
80085 ANEMIA PROFILE BLOOD WORK RL 0 30.80
041780 URINE BLOOD BLOOD WORK RL 1 58.75
84231 DRUG SCREEN RL 1 34.00
134 DIGOXIN LEVEL RL RL 99 51.00
7
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 PROCEDURE FEES PAGE 4
PROCEDURE DESCRIPTION ALT, DESC, DEPT T,O,5, STD. FEE
d2565A CREATO INE RL RL 99 28.50
881F5 PAP W/ MATURATION INDEX MATURATION RL 0 36.00
88172 BREAST CYTOLOGY RL 1 ,00
85615 ESR RL 1 26.00
86650 FTA BLOOD WORK RL 0 ,n0
RPR RPR RL 1 23.00
84165 IMMUNOGLOBULIN ELECTROPHORESIS BLOOD WORK RL 1 .00
82365 STONE ANALYSIS RL 1 57.00
83545 IRON BINDING CAPACITY BLOOD WORK RL 1 .00
87208 STOOL 0 AND P RL 0 62.00
87211 WET PREP RL 5 12.00
82660 DRUG SCREEN BLOOD WORK RL 1 50.00
86403 BETA STREP CULTURE RL 0 65.50
81002-GP URINE DIPSTICK RL 1 8,00
82009 SERUM KETONES BLOOD WORK RL 1 ,00
87081 THROAT CULTURE BLOOD WORK RL 1 14.00
140A LIPID PROFILE RL RL 99 31.61
87117 AFB CULTURE & SMEAR RL 5 65.00
83718A CHOLESTEROL, HDL RL RL 99 38,00
87101 SPUTUM FUNGAL CULTURE RL 0 .00
147 RHEUM PANEL B RL RL 99 39,00
80072 RHEUM PANEL B BLOOD WORK RL 0 37.71
84520A BUN (URIC NITROGEN) URIC RL 99 27.75
82955 G6PD BLOODWORK RL 99 60.75
82310 CALCIUM 82310 RL 0 33,00
82524 INSULIN TESTING BLOODWORK RL 99 .00
87178 DNA PROBE BLOOD WORK RL 0 38.45
82643 DIGOXIN LEVEL BLOOD WORK RL 0 58.00
86225 MUMPS TITER BLOOD WORK RL 0 58.50
80031 VALPORIC ACID RL 0 68.50
141 LIVER PANEL RL RL 99 26.00
84295 SODIUM RL 99 .00
82540 RL 1 .00
85048 WBC BLOOD WORK RL 5 .00
86994 C. DEFICILE TOXIN RL 1 .00
88108 CYTOLOGY SPUTUM RL 0 .00
80061 LIPID PROFILE BLOOD WORK RL 0 40.00
86244 ALPHAFETOPROTEIN BLOODWORK RL 1 .00
82465A CHOLESTEROL, TOTAL RL RL 99 28.00
80059 HEPATITIS PANEL BLOOD WORK RL 0 .00
84180 24 HR, URINE PROTEIN RL 0 .00
87207 MALARIA BLOOD WORK RL 1 ,00
31002 URINE DIPSTICK RL 0 8.00
82999 SERUM FRUCTOSAMINE BLOOD WORK RL 1 36.25
142 MULTICHEM PANEL 80019 RL 99 29.00
87250 VARICELLA ZOSTER CULTURE BLOOD WORK RL 1 .00
80009Y LIVER PROFILE BLOOD WORK RL 0 25.18
85730 PIT BLOOD WORK RL 1 37.00
82251 BILI T&D BLOODWORK RL 99 ,00
86032 ANTIBODY SCREEN BLOOD WORK RL 0 36.00
83020 HEMOGLOBIN ELECT. BLOOD WORK RL 1 .00
80082 BLOOD TYPING BLOOD WORK RL 1 .00
84045 DILANTIN LEVEL BLOOD WORK RL 0 60.00
8
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 PROCEDURE FEES PAGE 5
PROCEDURE DESCRIPTION ALT DESC. DEPT T.O.S, STD. FEE
33715 ' IPOPROTEIN BLOODWORK RL 5 .00
84144 PROGCSTERONE LEVEL RL 1 73,00
86319 CARBAMA?OPINE LEVEL BLOOD WORK RL 1 .00
84175 PROTEIN CSF RL 1 .00
07220 TOXICOLOGY SCREEN BLOOD WORK RL 1 ,10
87211Y WET PREP RL 0 12.00
87070 CULTURE, ANY OTHER SOURCE RL 1 .00
84550 URIC ACID BLOOD WORK RL 1 .00
83525 INSULIN BLOOD WORK RL 1 .00
86289 HER 8 CORE BLOOD WORK RL 1 .00
88180 T-CELL HEL./SUPP, PROF, BLOOD WORK RL 0 188.00
84006 PROSTATIC ACID PHOS, BLOOD WORK RL 1 55.00
86430 RHEUMATOID A BLOOD WORK RL 1 .00
136 ELECTROLYTE PANEL RL RL 99 24,05
148 RUBELLA TITER RL RL 99 42.00
84702 BETA HCG QUANT RL RL 99 31.00
87256 CHLAMYDIA IQG RL 0 82.75
144A POTASSIUM RL RL 99 22.25
86293 HEP BE AG BLOOD WORK RL 0 .00
82550 CPK BLOOD WORK RL 1 .00
85240 FACTOR VIII BLOOD WORK RL 0 .00
85544 L E CELL PREP BLOOD WORK RL 1 .00
135 DILANTIN RL RL 99 56.25
99001 HANDLING SPEC.-PT TO LAB RL 0 10.00
87177 STOOL D & P D & P RL 0 62.00
84701 PRENATAL PANEL 08 RL 0 36.00
84436 THYROID PROFILE BLOOD RL 1 .00
80050 EXECUTIVE III BLOOD WORK RL 0 53.00
82728 FERRITIN BLOOD WORK RL 1 58.50
86300 MONOSPOT 86300 RL 5 34.25
87076 AMA RL 0 .00
82270 HEMOCCULT BLOOD WORK RL 0 3.50
82470 CHOLESTEROL & ESTERS. BLOOD WORK RL 1 .00
84420 THEOPHYLLINE LEVEL BLOOD WORK RL 0 63.00
84681 C-PEPTIDE BLOOD WORK RL 1 .00
86082 BLOOD TYPE & RH BLOOD WORK RL 5 ,00
154 THYROID PANEL W/TSH RL RL 99 41.00
80053 EXECUTIVE D WITH TSH RL 1 60.00
86295 HEP BE AB BLOOD WORK RL 0 .00
82205Y PHENOBARBITAL RL 0 ,00
86280 ANTITHYROID ANTIBODIES BLOOD WORK RL 1 ,00
82374 CARBON DIOXIDE BLOOD WORK RL 1 .00
87075 ANARAIC CULTURE RL 1 .00
84185 BENCE JONES PROTEIN BLOOD WORK RL 1 .00
83317 VIRAL CULTURE RL 1 173.75
88107 CYTOLOGY JOINT FLUID BLOOD WORK RL 1 .00
208 XRAY THORACIC SPINE, 2 VIEWS W/INTERPRET XR XR 31 .00
230 XRAY OPP.VIEW FOR COMPARISON W/INTERPRET XR XR 31 .00
73100 WRIST XRAY 1 VIEW XRAY XR 0 .00
252 XRAY MANDIBLE 4 V W/INTERPRET XR XR 31 ,00
218 XRAY, CLAVICLE,l V W/INTERPRET XR XR 31 .00
71020 XRAY,CHEST,2 VIEWS, W/INTERPRET. XR XR 31 71.00
225 XRAY ELBOW, 3 VIEWS W/INTERPRETATION XR XR 31 ,00
9
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 2ROCEDURE FEES PAGE 6
PROCEDURE DESCRIPTION ALT, DESC, DEPT T,O.S, STD. FEE
71030 XRAY,CHEST, 3 VIEWS,W/INTREPRET, XR XR 0 96,00
251 XRAY SELLA TURCICA, 2 V W/INTERPRET XR XR 31 .00
197 XRAY,CHEST,2 VIEWS, W/INTERPRET, XR X0 31 .00
226 XRAY FOREARM, 2 VIEWS W/INTERPRET XR XR 31 .00
223 XRAY ACROMIOCLAV,JOINTS W/INTERPRET XR XR 31 .00
258 XRA4 FEMUR W/INTERPRET XR XR 31 .00
239 XRAY TIBIA&FIBULA W/INTERPRETATION XR XR 31 .00
220 XRAY SCAPULA, 3 V W/INTERPRETATION XR XR 31 .00
205 XRAY STERNO-CLAV.JOINTS,3VIEWS W/INTERPR XR XR 31 .00
206 XRAY CERVICAL SPINE, 2 VIEWS W/INTERPRET XR XR 31 .00
72110 XRAY,L/S SPINE,5 VIEWS W/INTERPRET, XR XR 0 128,00
198 XRAY,CHEST,3VIEWS,W/INTERPRET. XR XR 31 .00
203 XRAY RIBS,BILAT,W/CHEST PA & INTERPRET XR XR 31 .00
229 XRAY FINGER, 3 V W/INTERPRET XR XR 31 .00
245 XRAY SKULL 6 VIEWS W/INTERPRET XR XR 31 .00
200 XRAY RIBS,UNILATERAL,3VIEWS W/INTERPRETY XR XR 31 .00
72100 XRAY, L/S SPINE, 2 VIEWS W/INTERPRET. XR XR 0 96,00
255 TEM.MANDIBULAR JOINT,BILAT.6 V W/INTER, XR XR 31 .00
246 XRAY SKULL, 4 VIEWS W/INTERPRET XR XR 31 .00
243 XRAY FOOT 2 VIEWS W/INTERPRET XR XR 31 .00
256 XRAY NECK SOFT TISSUE 2 V W/INTERPRET XR XR 31 .00
71120 XRAY,STERUM, 3 VIEWS W/INTERPRET, XR XR 31 .00
71021 CHEST APICAL LORDOTIC X-RAY XR 1 47.00
253 XRAY ZYGOMATIC ARCHES,6V W/FACIAL&INTERP XR XR 31 ,00
71010 XRAY,CHEST, 1 VIEW W/INTEEPRET, XR XR 0 61.00
215 PELVIS, 3 VIEWS, W/INTERPRETATION XR XR 31 ,00
224 XRAY HUMERUS, 2 VIEWS W/INTERPRET XR XR 31 .00
240 XRAY ANKLE 2 VIEWS W/INTERPRET, XR XR 31 .00
250 XRAY SELLA TURCICA, 1 VIEW W/INTERPRET XR XR 31 .00
209 XRAY, L/S SPINE 2 VIEWS W/INTERPRET XR XR 0 .00
196 XRAY,CHEST,APICAL LORDOTIC W/INTERPRET. XR XR 31 .00
72070 XRAY, THORASIC SPINE,2 VIEWS W/INTERPRET XR XR 0 77.00
216 XRAY SACROILIAC JOINTS,4 V,W/INTERPRET XR XR 31 ,00
227 XRAY WRIST, 3 V W/INTERPRET XR XR 31 .00
234 XRAY ABDOMEN, 2 V W/INTERPRET XR XR 31 .00
213 XRAY PELVIS, STEREO,2 V W/INTERPRET XR XR 31 .00
195 XRAY,CHEST,1VIEW W/ INTERPRETATION XR XR 31 .00
237 XRAY KNEE, 2 VIEWS W/INTERPRETATION XR XR 31 .00
249 XRAY NASAL 80NES 4 V W/INTERPRET XR XR 31 .00
222 XRAY, SHOULDER, 3 V, W/INTERPRET XR XR 31 .00
210 L/S SPINE ,5 VIEWS W/INTERPRETATION XR XR 31 .00
259 XRAY TOES, W/INTERPRETATION XR XR 31 .00
221 XRAY SHOULDER, 2 V, W/INTERPRETATION XR XR 31 .00
232 XRAY NAVICULAR W/INTEPRET XR XR 31 .00
71130 XRAY STERNO-CLAV,JOINTS,3VIEWS W/INTER, XR XR 0 71.00
231 XRAY POST REDUCTION,2 V W/INTERPRET XR XR 31 .00
199 CHEST, 4 VIEWS W/INTERPRETATION XR XR 31 .00
219 XRAY CLAVICLE, 2 V W/INTERPRETATION XR XR 31 .00
228 XRAY HAND, 3 VIEWS W/INTERPET XR XR 31 .00
244 XRAY OS CALCIS, 2 VIEWS W/INTERPRET XR XR 31 .00
238 XRAY KNEE 3 VIEWS W/INTERPRETATION XR XR 31 ,00
247 XRAY SINUSES, 4 VIEWS W/INTERPRET XR XR 31 .00
72050 XRAY, CERVICAL SPINE,4-5 V W/INTERPRET. XR XR 0 116.00
10
ORANGE FAMILY MEDICAL GROUP PA
06/15/93 PROCEDURE FEES PAGE 7
PROCEDURE DESCRIPTION ALT, DESC, DEPT T,O,S, STD. FEE
74000 XRAY ABDOMEN 1 VIEW (KUB) KU8 XR 0 76.00
71110 XRAY,RIBS,BILAT, 6 VIEWS W/INTRRPRET, XR XR 31 80.00
204 XRAY STERNUM, 3 VIEWS W/INTERPRET XR XR 31 .00
214 XRAY PELVIS & LAT HIP, 2 V, W/INTERPRET, XR XR 31 ,00
242 XRAY FOOT, 2 VIEWS W/INTERPRET Xk XR 31 .00
207 XRAY CERVICAL SPINF,4-5 V W/INTERPRET XR XR 31 .00
70220 SINUS SERIES XR 0 ,00
72040 XRAY,CERVICAL SPINE, 2 VIEWS W INTERPRET XR XR 0 79,00
217 XRAY SACRUM & COCCYX W/INTERPRETATION XR XR 31 .00
241 XRAY ANKLE 3 VIEWS/W/INTERPRET, XR XR 31 .00
202 XRAY RIBS,BILAT. 6 VIEWS W/INTERPRET XR XR 31 .00
254 TEMP.MANDIBULAR JOINT,UNILAT 4 V W/INTER XR XR 31 .00
235 XRAY ABDOMEN,2 V W/PA CHEST & INTERPRET XR XR 31 .00
212 XRAY,PELVIS AP W/INTERPRETATION XR XR 31 .00
248 XRAY FACIAL BONES, 4 V W/INTERPRETATION XR XR 31 .00
201 XRAY RIBS,UNILAT.W/PA CHEST & INTERPRET XR XR 31 .00
257 XRAY SCOLIOSIS, 1 VIEW XR XR 31 .00
236 XRAY ABDOMEN, 3 V W/INTERPRET. XR XR 31 .00
211 XRAY SPINE, ENTIRE,AP & LAT W/INTERPRET XR XR 31 .00
233 XRAY ABDOMEN, SINGLE AP W/INTERPRET XR XR 31 ,00