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Cost Estimator
Mid-Valley Clinic
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Cash Pricing
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Misc.
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Select a Service
Select a service.
You may need to get a specific service code from your provider.
Code
Description
Virtual Communication Services
0002A
ADM SARSCOV2 30MCG/0.3ML 2ND
0011A
Immunization Administration Charge
0011A
Moderna Vaccine 1st Dose Administration
0012A
Immunization Administration Charge
0051A
Pfizer Vaccine 1st Dose Administration
0051A
Pfizer Vaccine Admin Ready To Use 1st Dose
0052A
fizer Vaccine 2nd Dose Administration
0052A
Pfizer Vaccine Admin Ready To Use 2nd Dose
0053A
Pfizer Vaccine 3rd Dose Administration
0054A
Pfizer Vaccine Booster Administration
0071A
PFIZER ADM SARSCV2 10MCG TRS-SUCR 1 MVHO
0072A
PFIZER ADM SARSCV2 10MCG TRS-SUCR 2 MVHO
0081A
Pfizer Pediatric First Dose
0082A
Pfizer Pediatric Second Dose
0112A
Moderna Vaccine 2nd Dose 0.25mL
0134A
Moderna Vaccine 1st Dose: 50mcg
0164A
Moderna Vaccine Booster Dose
1027M
M LOSS OF EARNING POWER FORM
1028M
M REVIEW OF JOB DESCRP. EA ADD
1038M
M REVIEW OF JOB DESCRIP/ANALYSIS
1040M
M ACCIDENT REPORT:WORKMANS COMP
1041M
M REOPEN CLAIM REPORT
1063M
M PHYS. REVIEW OF IME
1073M
M ACTIVITY PRESCRIPTION FORM
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