The following services are not covered by Medicare (all fees are subject to change):
Special authorization drug forms from private insurers $10
Missed gynecology consult appointments $25
Unemployment forms $10
Disability forms $25 - $80
Certificate of short-term illness or disability (off work note) $10
Chart transfer to Doctor/NP or lawyer $20 + $0.25 per page
Prescription call-in or fax-in $10
Third party requested letters/questionnaires $25 + $1 per page
Photocopying $0.25 per page
Rebooking of missed tests/consults $10
Proof of visits to doctor $10
Pessaries $45 - $70**
Copper IUDs $60**
Payment is due upon receipt of service. This list is not meant to be comprehensive; other charges for uninsured services may apply.
**Pessaries, IUDs and medical devices are sold at cost; price subject to change
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