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25E - AGMT - OCCUPATIONAL MED SRVS
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01/15/2019
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25E - AGMT - OCCUPATIONAL MED SRVS
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Last modified
1/10/2019 6:43:06 PM
Creation date
1/10/2019 6:34:45 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Human Resources
Item #
25E
Date
1/15/2019
Destruction Year
2024
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Exhibit A <br />Services and Pricing <br />i <br />.Services <br />Fees: <br />PE — BASIC VITALS, SNELLEN, UA, EXAM <br />$80.00 <br />PE — DOT <br />$99.00 <br />PR— RESPIRATOR CLEARANCE EXAM ONLY)! <br />$80.00 <br />AUDIOGRAM <br />$30.00 <br />REVIEW — QUESTIONNAIRE — GENERAL <br />$30.00 <br />REVIEW — QUESTIONNAIRE — RESPIRATOR <br />$30.00 <br />RESPIRATOR FIT TEST — QUALITATIVE <br />$50.00 <br />*HEPATITUS A TITER ANTIBODY — BLOOD <br />$50.00 <br />*HEPATITUS ABC PANEL (ACTIVE INFECTION/IMMUNUITY TEST) — <br />BLOOD <br />$275.00 <br />*HEPATITIS B —TITER SURFACT ANTIBODY QUANTITATIVE — BLOOD <br />$60.00 <br />*HEPATITIS C — ANTIBODY — BLOOD <br />$55.00 <br />*HIV <br />$94.00 <br />*VACCINE — HEPATITIS A 2 -DOSE SERIES <br />$138.00 per dose <br />*VACCINE — HEPATITIS B SHOW AS DOSE 1, DOSE 2, DOSE 3 <br />$100.00 per dose <br />*LEAD WITH ZPP — BLOOD <br />$61.00 <br />CHEM20/CHD/CBD/UA <br />$55.00 <br />*CBC W/DIFF <br />$25.00 <br />VENIPUNCTURE FEE <br />$0.00 <br />COLLECTION <br />$22.00 <br />*BLOOD CHESMISTERY PROFILE 24 <br />$80.00 <br />DS — URINE 7 PANEL NON DOT <br />$60.00 <br />DS — URINE 5 PANEL NON DOT <br />$55.00 <br />UA WITH MICRO — URINE <br />$28.00 <br />UA DIP STICK <br />Included in <br />physical <br />CHEST X-RAY 1 VIEW <br />$70.00 <br />VISION — ISHIHARA <br />$22.00 <br />EKG —WITH INTERPRETATION <br />$65.00 <br />PFT SPIROMETRY <br />$44.00 <br />CARDIAC STRESS TEST <br />$325.00 <br />*TB SKIN TEST 1 STEP <br />$37.00 <br />Expert Testimony <br />$250.00 per hour <br />x After the first twelve months of this Agreement, if the current market price for the above <br />Services change due to market conditions, demand(s) and/or shortage(s), the City will be <br />billed the then current market rate. <br />Agreement between City of Santa Ana and Concentra <br />25E-46 <br />12 <br />
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