| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $32 | 0% | $32 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
| Blood Test - Comprehensive Metabolic Panel | $48 | 0% | $48 |
| Blood Test - Folic Acid Level | $104 | 0% | $104 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | 0% | $109 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $107 | 0% | $107 |
| Destruction of Lesion (outpatient) | $379 | 0% | $379 |
| Lab Test - Detection test for Influenza Virus | $32 | 0% | $32 |
| Office Visit - Basic | $105 | 0% | $105 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $315 | 0% | $315 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $315 | 0% | $315 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $294 | 0% | $294 |
| Office Visit - Established Patient, High Complexity | $336 | 0% | $336 |
| Office Visit - Established Patient, Low Complexity | $168 | 0% | $168 |
| Office Visit - Established Patient, Moderate Complexity | $252 | 0% | $252 |
| Office Visit - New Patient, Low Complexity | $252 | 0% | $252 |
| Office Visit - New Patient, Minor | $168 | 0% | $168 |
| Office Visit - New Patient, Moderate Complexity | $336 | 0% | $336 |
| Psychiatric Diagnostic Evaluation | $116 | 0% | $116 |
| Psychotherapy - Family Session | $131 | 0% | $131 |
| Strep Test (Streptococcus, group A) | $32 | 0% | $32 |
| Urine Test - Pregnancy | $21 | 0% | $21 |
| Urine Test - Urinalysis, Manual Test | $21 | 0% | $21 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $105 | 0% | $105 |
