Clinical Services

100Uninsured office visit (age 2-49)130.00
120Uninsured complete physical exam (age 2-49) 165.00
                      A00049Uninsured phone visit 92.60
SGPMissed 10-minute appointment 50.00
SGPMissed long appointment80.00
00190+00044Cryotherapy for non-insured lesions65.00
13620 +00090Excision Mole (cosmetic)-non facial155.00
InjInjections (such as flu shots) for non eligible patients 20.00
A00049Advice by telephone on the establishing of a tentative diagnosis and prescribing treatment per 15 minutes or portion thereof92.60
A00001General Insurance Examination, industrial (to include M.O.T.$195.00 examinations for pilots and air traffic controllers), pre-placement and periodic examinations, CPP examinations220.00
96220OSMV Driver’s Medical Examination and Report (DMER)– stand-alone217.00
A00068Physical fitness examination for school, summer camp, etc., including certificateA0005878.40

Non-clinical Services

A00060One-page forms including: School/Work time off, Government UIC form, Parking form, Handi dart application40.00
A00070For filling out an ordinary printed form reporting on a patient’s condition or submitting like information in letter form, such as Employer’s Work Capability form177.00
A00070Insurance Company typed letter-short (½ page), Typed off work letter177.00
A00071A 5 or form is defined as a short factual written communication given to any lay person (e.g. lawyer, insurance representative) in relation to a patient for some purpose primarily unconnected with treatment
366.00
A00072A Medico-Legal Report is one, which will recite symptoms, history and records and gives diagnosis, treatment, results and present condition.This is a factual summary of all the information available on the case. It could also contain prognostic information about when the patient will be able to return to work and mightmention whether there will be a permanent disability1117.00

A00073
A Medico-Legal Opinion will usually include the information contained in the medical – legal report and will differ from it primarily in the field of expert opinion.  This may be opinion as to the course of events when these cannot be known for sure.  It can include opinion as to long term consequences and possible complications in the further development of the condition.  All the known facts will probably be mentioned, but in addition there will be extensive exercise of expert knowledge and judgement with respect to those facts with a detailed prognosis.1869.00
A00095Review of EMR records (15 min)107.00
A00047 Renewal of prescription by fax or telephone (per call)30.00
A00093Transferring charts out of clinic
This fee is recommended for a simple transfer of records. Photocopying may be charged in addition.ii).  Other direct costs, such as courier services, may be charged in addition based on the actual cost.iii). A fee for review of records may be charged in addition if the physician reviews the records for the purpose of selecting current and necessary medical information to be transferred.iv). Original records must be retained by the transferring physician as required by Lawv).  When multiple records are being transferred, the total time spent should be taken into account.
50.00
A00096Photocopying per page (paper copies) (first 10 pages)- subsequent pages – 30¢ per pageNOTES:i)     A00096 is extra to A00093 and/or A00095ii)    The fee for this service does not include review and/or summary of the patient’s chart   1.90
A94523Completion of Drug Benefit Form for third party insurer (including non-indicated Special Authority forms)75.00
A00069Insurance company form to include review of records-short report (1 page)158.00
A00059Insurance company form to include review of records-long report (more than 1 page)207.00

*Our fees are subject to change.