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BK:00025 PG:0014 <br />FY 12 -13 Proposed Vaccine Fees <br />Support Staff <br />Vaccine Cost Supply Cost Time <br />Item Description Per dose Per Item per 15 min <br />Infarix <br />25x1 Safety Glide Needlew / Syringe <br />Jr. Bandaid <br />Alcohol Pad <br />2x2 gauze ( non - sterile) <br />Copy of Shot Record <br />Staff Time <br />Ipol Polio <br />25x5/8 Integra Needle w /syringe <br />Jr. Bandaid <br />Alcohol Pad <br />Copy of Shot Record <br />2x2 gauze ( non - sterile) <br />Staff Time <br />Havrix Hep A Ped <br />25x1 Safety Glide Needle <br />Jr. Bandaid <br />Alcohol Pad <br />Copy of Shot Record <br />2x2 gauze ( non - sterile) <br />Staff Time <br />Engerix B Hep B <br />25x1 Safety Glide Needle <br />Jr. Bandaid <br />Alcohol Pad <br />2x2 gauze ( non - sterile) <br />Copy of Shot Record <br />Staff Time <br />Pedvaxhib Hib Ped <br />25x1 Integra Needle w /syringe <br />Jr. Bandaid <br />Alcohol Pad <br />2x2 gauze ( non - sterile) <br />Copy of Shot Record <br />Staff Time <br />Gardasil <br />25x1 Integra Needle w /syringe <br />Jr. Bandaid <br />Alcohol Pad <br />2x2 gauze ( non - sterile) <br />Copy of Shot Record <br />Staff Time <br />21.44 <br />-^ _ _ . 0.19 <br />0.02 j <br />0.01 <br />0.01 <br />0.01 <br />Nursing Time Admin Time Total Price of <br />per 15 min per 15 min Vaccine <br />II <br />EI • <br />ii <br />5.13 8.45 7.61 <br />2 -- -- -- - - _ -)V ,?.�.-- - -- <br />-- - -- <br />( <br />0.02 <br />0.01 <br />0.01 <br />0,01 - ` "` - - - -- <br />-- - -- - -- - -- 5.13 <br />I <br />I <br />49.00 <br />- 8.45 7.61 L 48.51 _ - _1 <br />15.06 <br />0.19 <br />0.02 <br />i <br />0.01 <br />}' <br />0.01 <br />0.01 <br />- <br />37.00 <br />5.13 <br />8.45 <br />7.61 <br />1 _ _36.49 <br />10.93 <br />_ <br />9 <br />-- - -- <br />- 0.19 <br />0.02 <br />0.01 <br />0.01 <br />Ili <br />- <br />0.01 <br />- i ' - <br />- <br />-- <br />33.00 <br />_ <br />- <br />5.13 <br />8.45 <br />7.61 <br />_ _32.36 <br />22.75 <br />0.56 <br />- <br />0.02 <br />i <br />I <br />t <br />0.01 <br />0.01 <br />i <br />0.01_ <br />}--- <br />45.00 <br />- <br />.13 <br />8.45 <br />7.61 <br />I . 44.55 <br />130.14 <br />-- - - <br />0 <br />- <br />1 <br />0.02 <br />. <br />0.01 <br />i <br />I <br />0.01 <br />0.01 <br />152.00 <br />5.13 <br />8.45 <br />7.61 <br />I_ 151 <br />page 1 of 2 <br />