1 | Name | Total Price | Internal Service Codes |
|---|---|---|---|
2 | Form - Schools/Camps | $ 36.00 | vh1 |
3 | Form - Admission to Educational Institution | $ 36.00 | vh2 |
4 | Form - Pre-employment Certification of Fitness | $ 54.00 | vh3 |
5 | Form - Hospital/Nursing Home Employees | $ 48.00 | vh4 |
6 | Medical Examination - Driver | $ 168.00 | vh5 |
7 | Medical Examination - Civil Aviation Report (/hr) | $ 180.00 | vh6 |
8 | Pilots License Validation (/hr) | $ 180.00 | vh7 |
9 | Sick Note - Work/Back to Work | $ 36.00 | vh8 |
10 | Sick Note - University Specific | $ 48.00 | vh9 |
11 | Immunization Record/Form for Work/School | $ 60.00 | vh10 |
12 | OCF-18 Treatment Plan | $ 180.00 | vh11 |
13 | OCF-3 Disability Certificate | $ 180.00 | vh12 |
14 | OCF-19 Determination of Catastrophic Impairment | $ 144.00 | vh13 |
15 | OCF-23 Treatment Confirmation | $ 174.00 | vh14 |
16 | Form - Travel Cancellation Insurance | $ 60.00 | vh15 |
17 | Life Insurance Death Certificate | $ 60.00 | vh16 |
18 | Employment Insurance Compassionate Care Benefits | $ 72.00 | vh17 |
19 | Attending Physicians Statement | $ 192.00 | vh18 |
20 | System - Specific or Disease Specific Questionnaire | $ 120.00 | vh19 |
21 | Insurance Medical Examination | $ 300.00 | vh20 |
22 | System - Specific Examination | $ 144.00 | vh21 |
23 | Report - Full Narrative/Clarification (/hr) | $ 480.00 | vh22 |
24 | Additional Assessment Fee | $ 120.00 | vh23 |
25 | Govt - CPP Disability Medical Report | $ 102.00 | vh24 |
26 | Govt - CPP The Narrative Medical Report | $ 180.00 | vh25 |
27 | Govt - Revenue Canada, Fed Disability Tax Credit | $ 90.00 | vh26 |
28 | Govt - CAS App. for Prospective Foster Parent | $ 72.00 | vh27 |
29 | Govt - Employment Insurance Sickness Benefits | $ 48.00 | vh28 |
30 | One Step/Two Step TB Test for work (Injection) | $ 72.00 | vh29 |
31 | One Step/Two Step TB Test for work (Read) | $ 24.00 | vh30 |
32 | Paps (if exceed Annual OHIP Insured Limit) | $ 72.00 | vh31 |
33 | Ear Syringing (if not obstructing hearing) (/ear) | $ 36.00 | vh32 |
34 | Copy from the PT Chart, up to 20 pages (/pg) | $ 1.20 | vh33 |
35 | Copy of the Full Chart, up to 20 pages | $ 36.00 | vh34 |
36 | Copy of the Full Chart, exceeding 20 pages (/pg) | $ 0.30 | vh35 |
37 | Massage/Physical Therapy Referral | $ 36.00 | vh36 |
38 | No OHIP or Expired Health Card Visit Fee | $ 120.00 | vh37 |
39 | Pre-op Assessment (by General Practitioner) | $ 180.00 | vh38 |
40 | Lost Requisition/Referral | $ 6.00 | vh39 |
41 | Travel Advice & Vaccine Admin (/consult) | $ 96.00 | vh40 |
42 | Travel Advice & Vaccine Admin (/familiy) | $ 144.00 | vh41 |
43 | Travel Advice & Vaccine Admin (>5 members) | $ 168.00 | vh42 |
44 | Form - Youth Physical | $ 58.80 | vh43 |
45 | Vaccine (General) | $ 102.00 | vh44 |
46 | Wart Removal by Liquid Nitrogen (up to 3) | $ 30.00 | vh45 |
47 | Form - Complex Completion | $ 48.00 | vh46 |
48 | Pregnancy Test | $ 12.00 | vh47 |
49 | Vaccine - ACT-HIB 0.5 mL | $ 78.00 | vh48 |
50 | Vaccine - Tetanus, Diphtheria, Pertussis | $ 81.60 | vh49 |
51 | Vaccine - Adacel-Polio | $ 78.00 | vh50 |
52 | Vaccine - Bexsero (Meningitis B) | $ 192.00 | vh51 |
53 | Vaccine - Chicken Pox (Varivax III / Varilix) | $ 144.00 | vh52 |
54 | Vaccine - Dukoral | $ 78.00 | vh53 |
55 | Vaccine - Gardasil 9 HPV | $ 270.00 | vh54 |
56 | Vaccine - Hep A (Avaxim, Havrix) | $ 100.80 | vh55 |
57 | Vaccine - Hep B (Engerix B / Recombivax) | $ 78.00 | vh56 |
58 | Vaccine - Hep A & B (Twinrix) (Adult) | $ 108.00 | vh57 |
59 | Vaccine - Hep A & B (Twinrix) (Pediatric) | $ 80.40 | vh58 |
60 | Vaccine - Japanese Encephalitis (Ixiaro) | $ 288.00 | vh59 |
61 | Vaccine - Menjugate | $ 114.00 | vh60 |
62 | Vaccine - Menactra (Mengingococcal ACYW-135) | $ 192.00 | vh61 |
63 | Vaccine - Menveo (Mengingococcal ACYW-135, HALAL) | $ 174.00 | vh62 |
64 | Vaccine - MMR (MMRII / Priorix) | $ 78.00 | vh63 |
65 | Vaccine - MMRV | $ 78.00 | vh64 |
66 | Vaccine - Prevnar 13 (Penumococcal) | $ 156.00 | vh65 |
67 | Vaccine - Pneumovax 23 (Penumococcal) | $ 78.00 | vh66 |
68 | Vaccine - Polio IPV | $ 102.00 | vh67 |
69 | Vaccine - Rabies (Rabavert / Imovax Rabies) | $ 300.00 | vh68 |
70 | Vaccine - Rotavirus (Rotateq / Rotarix) | $ 108.00 | vh69 |
71 | Vaccine - Tetanus & Diphtheria | $ 78.00 | vh70 |
72 | Vaccine - TDPolio | $ 78.00 | vh71 |
73 | Vaccine - Travelers Diarrhea, Cholera | $ 74.40 | vh72 |
74 | Vaccine - Typhoid (Injectable / Oral) | $ 87.60 | vh73 |
75 | Vaccine - Yellow Fever | $ 276.00 | vh74 |
76 | Vaccine - Shingles (Zostavax) | $ 258.00 | vh75 |
77 | Vaccine - Shingles (Shigrix) | $ 198.00 | vh76 |