Base Charge: Hours in the consultation multiplied by the doctor's hourly rate. Emergency Surcharge: For consultations that begin before 6 AM or on or after 8 PM the emergency surcharge is $100. Add to Base Charge. Addiction Surgharge: For Substance Abuse or Aversion Therapy consultations, the surcharge is 40% of Base Charge. Add to Base Charge. Long Consult Discount: For patients whose consultation lasted 2 hours or longer, the discount is 30% of Base Charge. Subtract from Base Charge. Minimum Adj Charge: For all people 70 or older, the minimun adjusted pay is $20; for all other people the minimum adjusted pay is $40. Totals Consult Hours 5.00 Base Emergency Addiction Charge Surcharge Surcharge $375.00 Long Consult Discount Minimum Adjusted Adjusted Charge Charge Dr Last Dr First Name Name Dr Speciality Fletcher Alexandra Substance Abuse Cline Juan Brain Surgery Fletcher Alexandra Substance Abuse Chapas Jodi Podiatry Chapas Jodi Podiatry Fletcher Alexandra Aversion Therapy Chapas Jodi Podiatry Fletcher Alexandra Aversion Therapy Lopez Jared Cosmetology Hadyka Thaisy Substance Abuse Shuemaker Barbara Phrenology Chapas Jodi Podiatry Shuemaker Barbara Phrenology Hadyka Thaisy Substance Abuse Shuemaker Barbara Phrenology Shuemaker Barbara Phrenology Chapas Jodi Podiatry Hadyka Thaisy Substance Abuse Cline Juan Brain Surgery Shuemaker Barbara Phrenology Shuemaker Barbara Phrenology Chapas Jodi Podiatry Hadyka Thaisy Substance Abuse Dr Rate $75.00 $275.00 $75.00 $105.00 $105.00 $75.00 $105.00 $75.00 $45.00 $40.00 $75.00 $105.00 $75.00 $40.00 $75.00 $75.00 $105.00 $40.00 $275.00 $75.00 $75.00 $105.00 $40.00 Patient Gender F M F M M F M F M F M M M M M M M M M M F F F Patient Age 92 78 78 50 87 72 90 85 37 50 101 61 50 50 37 49 52 67 50 67 44 58 42 Extended Coverage Yes Yes Yes Yes No Yes No Yes No No No No No No No Yes Yes Yes No Yes Yes Yes No State Consult Resident Date Time In Time Out Yes 01-Oct-98 5:15 AM 10:15 AM Yes 01-Oct-98 8:30 PM 9:15 PM Yes 01-Oct-98 8:45 AM 11:45 AM Yes 01-Oct-98 8:45 AM 10:30 AM Yes 01-Oct-98 9:15 AM 10:45 AM Yes 01-Oct-98 12:00 PM 12:45 PM No 01-Oct-98 12:00 PM 12:30 PM Yes 01-Oct-98 12:30 PM 1:00 PM Yes 01-Oct-98 12:30 PM 2:45 PM Yes 01-Oct-98 1:00 AM 4:30 AM Yes 02-Oct-98 8:45 AM 9:00 AM Yes 02-Oct-98 9:30 AM 10:15 AM No 02-Oct-98 9:45 PM 11:15 PM No 02-Oct-98 10:15 AM 12:30 PM Yes 02-Oct-98 11:30 AM 1:00 PM Yes 02-Oct-98 11:30 AM 12:15 PM Yes 02-Oct-98 1:00 PM 4:00 PM No 02-Oct-98 1:30 PM 2:00 PM Yes 03-Oct-98 8:15 AM 9:15 AM No 03-Oct-98 8:15 AM 10:30 AM No 03-Oct-98 8:15 AM 9:00 AM No 05-Oct-98 8:15 AM 9:30 AM Yes 05-Oct-98 8:15 AM 9:15 AM
