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EXHIBIT D <br /> <br /> TO <br /> <br />AGREEMENT FOR INMATE MEDICAL SERVICES <br />COST SCHEDULE FOR CHARGEBACK SERVICES <br /> <br />K. COST SCHEDULE FOR CHARGEBACK SERVICES <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />5. <br /> <br />Denture, partial plate and bridge repair <br /> <br />X Ray services <br /> <br />Opthamology services <br /> <br />OB/GYN services <br /> <br />Emergency Psychiatric Crisis <br />Intervention & Evaluation <br /> <br />Monthly Administrative fee for <br />Off-site Emergency Medical <br /> Billing Services <br /> <br />$200 Ea <br />$48/58 Ea <br />$150 Ea <br />$150 Ea <br />$50 Ea <br /> <br />$400 <br /> <br />Month <br /> <br /> <br />