HAWC
Sliding Fee Scale Effective 03/01/09
Annual Income

 

FROM

TO

FROM

TO

FROM

TO

FROM

TO

MORE

THAN

0

10830

0

14570

0

18310

0

22050

0

25790

0

29530

0

33270

0

37010

0

40750

0

44490

$40.00

$50.00

$60.00

$70.00

100%

The patient is always responsible for some part of the bill.  If the percentage is less than our minimum charge the patient will pay the minimum.
SIZE
1

 10831

 13538

 13539

 16245

 16246

 21660

 21660
2

 14571

 18213

 18214

 21855

 21856

 29140

 29140
3

 18311

 22888

 22889

 27465

 27466

 36620

 36620
4

 22051

 27563

 27564

 33075

 33076

 44100

 44100
5

 25791

 32238

 32239

 38685

 38686

 51580

 51580
6

 29531

 36913

 36914

 44295

 44296

 59060

 59060
7

 33271

 41588

 41589

 49905

 49906

 66540

 66540
8

 37011

 46263

 46264

 55515

 55516

 74020

 74020
9

 40751

 50938

 50939

 61125

 61126

 81500

 81500
10

 44491

 55613

 55614

 66735

 66736

 88980

 88980
Patient
QUALIFIES FOR PFIZER DRUG PROGRAM

Sliding Fee Scale Effective 03/01/09
Monthly Income

 

FROM

TO

FROM

TO

FROM

TO

FROM

TO

MORE

THAN

0

903

0

1214

0

1526

0

1838

0

2149

0

2461

0

2773

0

3084

0

3396

0

3708

$40.00

50.00

$60.00

$70.00

100%

The patient is always responsible for some part of the bill.  If the percentage is less than our minimum charge the patient will pay the minimum.
SIZE
1

 904

 1128

 1129

 1354

 1355

 1805

 1805
2

 1215

 1518

 1519

 1821

 1822

 2428

 2428
3

 1527

 1907

 1908

 2289

 2290

 3052

 3052
4

 1839

 2297

 2298

 2756

 2757

 3675

 3675
5

 2150

 2686

 2687

 3224

 3225

 4298

 4298
6

 2462

 3076

 3077

 3691

 3692

 4922

 4922
7

 2774

 3466

 3467

 4159

 4160

 5545

 5545
8

 3085

 3855

 3856

 4626

 4627

 6168

 6168
9

 3397

 4245

 4246

 5094

 5095

 6792

 6792
10

 3709

 4634

 4635

 5561

 5562

 7415

 7415
Patient
Pays
QUALIFIES FOR PFIZER DRUG PROGRAM