| Blood Test - Hepatic (Liver) Function Panel | $43 | N/A | $43 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $28 | N/A | $28 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | N/A | $109 |
| Blood Test - Vitamin D-3 Level | $287 | N/A | $287 |
| Office Visit - Basic | $79 | N/A | $79 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $273 | N/A | $273 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $315 | N/A | $315 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $242 | N/A | $242 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $242 | N/A | $242 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $257 | N/A | $257 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $215 | N/A | $215 |
| Office Visit - Established Patient, High Complexity | $242 | N/A | $242 |
| Office Visit - Established Patient, Low Complexity | $121 | N/A | $121 |
| Office Visit - Established Patient, Moderate Complexity | $184 | N/A | $184 |
| Office Visit - New Patient, Low Complexity | $194 | N/A | $194 |
| Office Visit - New Patient, Minor | $128 | N/A | $128 |
| Office Visit - New Patient, Moderate Complexity | $284 | N/A | $284 |
| Urine Test - Urinalysis, Manual Test | $20 | N/A | $20 |
