| Bacterial Culture - Swab | $37 | 0% | $37 |
| Blood Test - Clotting Time | $17 | 0% | $17 |
| Blood Test - Coagulation Assessment | $25 | 0% | $25 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | 0% | $33 |
| Blood Test - Comprehensive Metabolic Panel | $45 | 0% | $45 |
| Blood Test - Electrolytes Panel | $29 | 0% | $29 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $71 | 0% | $71 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $37 | 0% | $37 |
| Lab Test - Detection test for Influenza Virus | $51 | 0% | $51 |
| Lab Test - Smear for Microorganism | $18 | 0% | $18 |
| Office Visit - Basic | $147 | 0% | $147 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $232 | 0% | $232 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $270 | 0% | $270 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $305 | 0% | $305 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $326 | 0% | $326 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $336 | 0% | $336 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $368 | 0% | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $310 | 0% | $310 |
| Office Visit - Established Patient, High Complexity | $483 | 0% | $483 |
| Office Visit - Established Patient, Low Complexity | $186 | 0% | $186 |
| Office Visit - Established Patient, Moderate Complexity | $357 | 0% | $357 |
| Office Visit - New Patient, Low Complexity | $300 | 0% | $300 |
| Office Visit - New Patient, Moderate Complexity | $400 | 0% | $400 |
| Strep Test (Streptococcus, group A) | $39 | 0% | $39 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $53 | 0% | $53 |
