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INDIAN RIVER COUNTY HEALTH DEPARTMENT <br /> FEE SCHfo"E <br /> 1 u s,,� ,x. -' t •. 4%d 60113 <br /> ?r '33°u�keC �50°/da D TFnm:q-�_ <br /> ; F, *00%`100' �X�12�13,Influenza $0.00 $3.23 $6.27 $9.50 .77 $19.00 19.00Pneumococcal Pneumonia $0.00 $11.053250 .95 $65.00 65.00Measles/Mumps/Rubell <br />a $0.00 $11.05 $21.44 $32.493.93 $64.98 64.98Tetanus $0.00 $6.64 $12.89 $19.532.41 $39.05 39.05Tdap $0.00 $8.84 $17.16 $26.01 <br /> . 3.17 $52.01 52.01 <br /> Injected Polio Vaccine $0.00 $7.51 $14.57 $22.08 $29.58 $36.64 $44.15 44.15 <br /> Varivax(Chicken Pox) $0.00 $20.64 $40.07 $60.71 $81.35 :6100.78 $121.42 121.4'2 <br /> Meningococcal $0.00 $20.92 $40.60 $61.52 $82.44 $102.12 $123.04 123.04 <br /> Rabies Vaccine(per injection) $0.00 $30.60 $59.40 $90.00 $120.60 $149.40 $180.00 180.00 <br /> RIG - Per2cc Vial $0.00 $37.40 $72.60 $110.00 $147.40 $182.60 $220.00 220.00 <br /> Hepatitis A Vaccine(per injection) $0.00 $7.22 $14.01 $21.23 $28.45 $35.24 $42.46 $42.46 <br /> Hepatitis B Vaccine(per injection) $0.00 $8.43 $16.35 $24.78 $33.21 $41.13 $49.56 $49.56 <br /> Twinrix-Hep A ci B(per injection $0 00 $11.24 $21 81 $33 05 $44 29 $54.86 $66.10 $66.10 <br /> � � r 170.32 170.32 <br /> Shin les Vaccine r; +� )�� ma; N $LI IN,,. EE � '....�40 � $ <br /> Cervical Cancer Vaccine $0.00111 $24.23 $47..03 $71.27 $95.50 $118.30 $142.53 142.53 <br /> Per CDC guidelines,vaccine for childhood immunizations are covered under the Vaccine for Children Program and are rovided at no cost to children <br /> age 0-18. Charges for communicable disease control issues will be waived with authorization. <br /> CY 12-13 <br /> Travel Immunization Consult Visit $35.00 <br /> Administration Fee-90471 $5.00 <br /> Administration Fee,additional shot-90472 $5.00 <br /> Hepatitis B Vaccine $49.56 <br /> "All vaccines will be chargeable at cost <br /> Hepatitis B Vaccine-Children $40.86 plus$20.00 on the last received invoice <br /> Hep B Immune Globulin*per ml $130.00 <br /> by Indian River County Health Department <br /> Hepatitis A Vaccine $42.46 <br /> Hepatitis A Vaccine-Children $48.09 <br /> Hep A Immune Globulin* $60.00 Per 2 ml dose <br /> Twinrix(Hep A&B) $66.10 <br /> Meningococcal 1 <br /> Tetanus $339.0 <br /> 04 <br /> 2.0 <br /> Tdap* $ <br /> Typhoid $699.7.7 <br /> 5 <br /> $101.05 <br /> Yellow Fever <br /> *As available <br /> Page 4 of 9 <br /> w <br /> .1 <br />