HomeMy WebLinkAboutC.054.93010_0177 (2)57170
Diaphra¢m Fitting
$ 70 00
96110
Denver Developmental
S 150 00
92451
Audiometry
$ 30 00
69210
Ear Irrigation
S 60 00
Immunizatlun(Iniection
90782
TherapeuticlDmgnosuc
S 1000
Adnun. Fee
90471
Adnun. Single Vaccine
$ 1000
90472
Admin. 2+ Vaccine
S 1500
CPT CODES
SERVI E
FEES
90788
Adnun. Antibiotics
S 1000
90384
Rho Gam
5110.00
11055
DepoProvera
S 45.00
90716
*Adult Varicella
S 55.00
90707
'Adult MMR
$4000
90733
'Adult Meningitis
S 65 00
90746
'Adult Hepatitis B
S4500
90632
'Adult Hepatitis .A
$5000
90633
'Ped/Adol Hepatitis A
S 25.00
90657 &
90658
'Influenza Vaccine
S 900
90732
i
'Pneumonia Vaccine
51600
86580
'PPD (TB Skin Test)
S 1000
Miscellaneous
Adult Health Visit
S4000
'Pill Replacement Pack
$ 700
•TRUST
$2000
•Chem 23 (co employe•. only)
S 40 00
j
•CBC (co employee only)
S 25 00
#'Lipid Profile
S 30.00
................................................
Fees listed are only those which are new, have codes assigned, or have changed in amounts since
January 1, 2000,
Sliding Fee Scale applied except as noted
*Fiat Fee except as prohibited by law, regulation or fee policy (if part of clinic packaged service,
will be billed on sliding scale or to third parties regardless of age J
**Based on materials used
#*Flat Fee and if in conjunction with Allied Health nutritional education, an additional $10 00
will be added to the fee.
ALLEED HEALTH DIVISION
Dental, Health Promotion mrd Nutrition Secamis
FV'99-'00 Fl"00-'Ol
Services for Community Members/Organizations
Basic Cholesterol Screening and Nutrition Education ................... S 10.00..... 830.00
Full Lipid Profile and Nutrition Education .......... _ ............ _ ... 29.00...... 40.00
Breast Pump Rental (per month)20 ...... 2000
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