X016

PDF page 363 / D5

DIAGNOSTIC RADIOLOGY
      HEAD AND NECK
                                                                                                                   H      P
                 Skull
               X001 - four views ...........................................................................      29.90   14.45
               X009 - five or more views ..............................................................           37.25   17.90
               X003 Sella turcica (when skull not examined) .................................                     14.90    7.00
                 Facial bones
               X004 - three views .........................................................................       21.70   11.25
                 Nose
               X005 - two views............................................................................       14.90    7.00
                 Mandible
               X006 - three views (unilateral or bilateral) .....................................                 21.70   11.30
               X012 - four or more views..............................................................            29.90   14.45
               X007 Temporomandibular joints - four views including open and
                      closed mouth views ............................................................             21.70   11.30
                 Mastoids
                    - bilateral
               X010      - six views...........................................................................   28.65   15.55
               X011 - Internal auditory meati (when skull not examined) .............                             21.70   11.30
                   Note:
                   Dental x-rays of the teeth are not an insured benefit.
               X016 Eye, for foreign body...............................................................          14.85    9.90
               X017 Eye, for localization, additional ...............................................             15.30   22.25
               X018 Optic foramina ........................................................................       16.85    9.90
               X019 Salivary gland region ..............................................................          13.75    8.70
                 Neck for soft tissues
               X020 - two views............................................................................       13.75    8.70

Master, record 6505. Record Layout PDF, page 1.

X01620260401999999990000000000000000186000000000000000000000000000000099000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.