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William H. Nuesse, M.O. and Mary Ann Nuesse, D,O., a Medical Corporation <br />dba Sunrise Multispeclallst Medical Center <br />Exhibit A <br />City of Santa Ana Non-tndustrial Medical Services <br />Physicals: <br />Basic Employer Physical (includes UA dip, distance vision, basic color vision) $35.00 <br />Annual Employer Physical (includes UA dip, distance vision, basic color vision) $35.00 <br />Pre -Employment Physical (includes UA dip, distance vision, basic color vision) $35.00 <br />Fit For Duty/Return toWork (MUST hove copy otjob description) $40.00 <br />Commercial Driver Exams $55,00 <br />Resoiratory Fit Testing: <br />Respiratory Eva]nation (includes: Mask Fit Test, OSHA questionnaire review, PFT) $90.00 <br />PFT $40.00 <br />OSHA Questionnaire Review $25.00 <br />Mask fit Test $25.00 <br />Drug Screens; <br />Breath Alcohol Test $30.00 <br />5 Panel Rapid $15.00 <br />10 panel Rapid $20.00 <br />9 Panel Non -Dot it1793N $25.00 <br />10 Panel Non -Dot #6633N $30.00 <br />DOT Drug Screen $25.00 <br />MRO Interpretation of Positive Drug Screen $25.00 <br />Drug Screen Collection only (Nat on Sunrise's lab account) $$5,00 <br />V sion Testin <br />ishihara <br />$10.00 <br />Near Vision <br />$5.00 <br />Jaeger <br />$5.00 <br />Snellen & Basic Color <br />$5.00 <br />Other Services: <br />Audiograms <br />$15,00 <br />Lift Test— Floor to Waist <br />$5.00 <br />Lift Test— Waist to Chest <br />$5.00 <br />EKG <br />$30.00 <br />TB/PPD Skin Test <br />$28.00 <br />Chest X-Ray (2 Views rule out TB) <br />$30,00 <br />