| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $37 | 0% | $37 |
| Blood Test - Cholesterol Test, Lipid Panel | $63 | 0% | $63 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | 0% | $33 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $112 | 0% | $112 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $176 | 0% | $176 |
| Office Visit - Basic | $79 | 0% | $79 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $236 | 0% | $236 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $263 | 0% | $263 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $205 | 0% | $205 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $221 | 0% | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $226 | 0% | $226 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $184 | 0% | $184 |
| Office Visit - Established Patient, High Complexity | $215 | 0% | $215 |
| Office Visit - Established Patient, Low Complexity | $110 | 0% | $110 |
| Office Visit - Established Patient, Moderate Complexity | $168 | 0% | $168 |
| Office Visit - New Patient, Low Complexity | $163 | 0% | $163 |
| Office Visit - New Patient, Minor | $121 | 0% | $121 |
| Office Visit - New Patient, Moderate Complexity | $263 | 0% | $263 |
| Urine Test - Automated without Microscope | $21 | 0% | $21 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $68 | 0% | $68 |
