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41 <br /> Attachment 7. Orange County Fee Schedule <br /> Last <br /> Department/Program Description Current Fee Revision <br /> Resin I sur pos prim $75.00 1997 <br /> Resin 2 sur pos prim 1$100.00 1997 <br /> Resin 3sur pos prim 1$125.00 1997 <br /> Resin I sur pos perm 1$75.00 1997 <br /> (Resin 2 sur s perm 1$100.00 1997 <br /> Resin 3 sur pos perm 1$125.00 1997 <br /> !Prefab resin crown 1$150.00 1999 <br /> Prefabricated SSC w.Resin Crown $150.00 1999 <br /> SSC permanent $150.00 1997 <br /> Pulp cap direct $40.00 1992 <br /> Pulp cap indirect $40.00 1992 <br /> Biopsy Oral Tissue $75.00 1992 <br /> Minimum Fee $25.00 1999 <br /> Family Planning Norplant Removal/Reinsert $703.11 1995 <br /> Norplant Removal $197.11 1995 <br /> Initial Visit $136.38 1995 <br /> Compi Physical $87.80 1995 <br /> Extended Visit ;$74.14 1995 <br /> Ltd Revisit 1$43.28 1995 <br /> Depo Provera Injection '$24.93 1995 <br /> Maternal Health*** Home Visit,Prenatal lEgh Risk $108.05 1995 <br /> MCC Initial $92.97 1995 <br /> Parenting Class '$92.38 1995 <br /> Childbirth Class '1$87.00 1995 <br /> Complete Prenatal $85.56 1995 <br /> Maternal MOW-Extended $79.50 1995 <br /> Home Visit,Newborn Screen $54.76 1995 <br /> Maternal MOW-Brief $54.66 1995 <br /> MCC Home Visit ($50.75 1995 <br /> MCC Subsequent 1$47.02 1995 <br /> Home Visit,Newborn Assmt 1$36.92 1995 <br /> Home Visit,Postpartum $36.92 1995 <br /> Prenatal Nutrit Counseling j$33-89 1995 <br /> Ps chosocial Counseling !$33.25 1995 <br /> Refresher Childbirth Class $30.00 1995 <br /> Glucose Tolerance ;$19.65 1995 <br /> Maternal MOW-Std $19.54 1995 <br /> Child Health*** Child Sery Coord $86.43 1995 <br /> Child Screen Periodic $82.46 1995 <br /> Child Screen In riodic $82.46 1995 <br /> Child MOW Brief $19.54 1995 <br /> Child MOW Std 554.66 1995 <br /> Child MOW Extended $79.50 1995 <br /> Child Health Treatment 552.69 1995 <br /> EPSDT Screen $82.46 1995 <br /> Immunization Update $16.48 1995 <br /> Child Nutrition Therapy $35.16 1995 <br /> Infant Care Seat ,$24.00 1999 <br /> Toddler Car Seat $42.00 1999 <br /> Epidentiology*** Tuberculosis $82.77 1995 <br /> Influenza 1$8.00 1999 <br /> Pneumococcus 510.00 1995 <br /> Herpes 540.99 1995 <br /> Trich 1$40.99 1995 <br /> Yeast $40.99 1995 <br /> NGU 540.99' 1995 <br /> NS V 540.99 1995 <br /> IChlam dia 540.99 '995 <br /> Appendix D-9 <br />