Acupuncture
Item 195
| Patients | Schedule Fee | Benefit 100% |
| One | $71.80 | $71.80 |
| Two | $57.00 | $57.00 |
| Three | $52.05 | $52.05 |
| Four | $49.60 | $49.60 |
| Five | $48.10 | $48.10 |
| Six | $47.15 | $47.15 |
| Seven+ | $44.55 | $44.55 |
| Patients | Schedule Fee | Benefit 100% |
| One | $71.80 | $71.80 |
| Two | $57.00 | $57.00 |
| Three | $52.05 | $52.05 |
| Four | $49.60 | $49.60 |
| Five | $48.10 | $48.10 |
| Six | $47.15 | $47.15 |
| Seven+ | $44.55 | $44.55 |