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INDIAN RIVER COUNTY HEALTH DEPARTMENT <br /> FEE SCHEDULE --Effective Nov.01, 2006 <br /> Laboratory Services 0%-A 17% -B 33% -C 50%-D 67% -E 83%- F 100%-G COST <br /> IN-HOUSE LAB <br /> LAB $0.00 $2.55 $4.95 $7.50 $10.05 $12.45 $15.00 $15.00 <br /> Contracted Laboratory Services <br /> LAB $0.00 $4.25 $8.25 $12.50 $16.75 $20.75 $25.00 $25.00 <br /> NOTE: Tests which exceed a charge of$100.00 will be billed individually on sliding fee scale percentage based on IRCHD cost of lab service. <br /> IN-HOUSE and CONTRACTED LAB Fee is for all labs performed at the time of service. <br /> Medical Records Fees <br /> Copy of Medical Record/per page $1.00 per page for the first 25 pages; $.25 each additional page thereafter. <br /> NOTE: Florida Statutes regarding release of medical records must be met prior to release of medical records to any source. No fees are <br /> charged to physician offices/other medical agents with the understanding that IRCHD will also be exempt from such payment. <br /> Vital Statistics Fees <br /> Birth Certificates(computer) $12.00 <br /> Birth Certificates(book) - $15.00 <br /> Additional Copies(computer) $8.00 <br /> Additional Copies(book) $8.00 <br /> Death Certificates $10.00 <br /> Research Fee(per year) $3.00 <br /> Expedite Fee $5.00 <br /> Overnight Shipment $10.00 <br /> Birth Certificates are provided free of charge to the following only: Children& Families Case Workers who are involved in a custody case. <br /> Case Worker must present proper ID, completed application request and copy of the signed court petition. Only one certified copy will be <br /> provided per six(6)month period. <br /> 10/23/2006CLFEE2006-07 Page 4 of 11 <br />