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    Financial Assistance for Uninsured Patients

    Family Size Period  FPG   Full, if income is below 351%   Partial, if income is Catastrophic, 351% to 500% if above 500%
    1 Annual $11,490.00 $40,215.00  $ 57,450.00
      Monthly $958.00 $3,353.00 $4,790.00
    2 Annual $15,510.00 $54,285.00 $77,550.00
      Monthly $1,293.00 $4,525.50 $6,465.00
    3 Annual $19,530.00 $68,355.00 $97,650.00
      Monthly $1,628.00 $5,698.00 $8,140.00
    4 Annual $2,355.00 $8,242.50 $11,775.00
      Monthly $1,963.00 $6,870.50 $9,815.00
    5 Annual $27,570.00 $96,495.00 $137,850.00
      Monthly $2,298.00 $8,043.00 $11,490.00
    6 Annual $31,590.00 $110,565.00 $157,950.00
      Monthly $2,633.00 $9,215.50 $13,165.00
    7 Annual $35,610.00 $124,635.00 $178,050.00
      Monthly $2,968.00 $10,388.00 $14,840.00
    8 Annual $39,630.00 $138,705.00 $198,150.00
      Monthly $3,303.00 $11,560.50 $16,515.00

    For families more than 8 persons, ass $4,020.00 for each additional persons.