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DocuSign Envelope ID: FF7F3462-A44C-4038-8086-1F69FF4E2441 <br />DocuSign Envelope IDI E63EEB40-6DE4.48E1-A808-30ACB3F24B10 <br />gELE SCHELIULH <br />TYPE OF MEDICAL PROCEDURE <br />M9llf]:B:ii#'S➢ <br />AUDIOGRAM <br />$ <br />25.00 <br />BACK X-RAY <br />$ <br />72.00 <br />BLOOD LEAD LEVEL ZZP <br />$ <br />61,00 <br />BLOOD SCREENS -7 panel drug screen <br />$ <br />86.00 <br />CHESTX-RAY <br />$ <br />55,00 <br />CORE EXAM* <br />$ <br />80.00 <br />DMV <br />$ <br />99,00 <br />HEP A BLOOD SCREEN <br />$ <br />50.00 <br />HEP B 4000 SCREEN <br />$ <br />5$.OD <br />HEP B BOOSTER <br />$ <br />100.00 <br />MEP 8 TITER <br />$ <br />55,00 <br />HERB VACCINE <br />$ <br />100,00 <br />HEP AVACCINE <br />$ <br />132,00 <br />HEP <br />$ <br />55.00 <br />HIV BLOOD SCREEN <br />$ <br />45,00 <br />PULMONARY FUNCTION TEST <br />$ <br />70.W <br />RESPIRATOR FITTEST <br />$ <br />50,00 <br />RESPIRATOR PHYSICAL (requires Pufnionary Function Test) <br />$ <br />80.00 <br />RESPIRATOROLIESTIONIAREIP PX IS NOTREQUIR£0 W/CLEARANCE <br />$ <br />28.00 <br />TB <br />$ <br />28,00 <br />URINALYSIS <br />$ <br />15.00 <br />URINE COLLECYION FEE <br />$ <br />28.00 <br />*Care exams are basic physicals: Include vital signs, vision testing, physical exam, and urinalysis. <br />8 <br />