| Developmental Screening | $26 | N/A | $26 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $399 | N/A | $399 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $263 | N/A | $263 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $299 | N/A | $299 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $299 | N/A | $299 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $263 | N/A | $263 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $263 | N/A | $263 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $278 | N/A | $278 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $326 | N/A | $326 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $263 | N/A | $263 |
| Office Visit - Established Patient, Low Complexity | $221 | N/A | $221 |
| Office Visit - Established Patient, Moderate Complexity | $263 | N/A | $263 |
| Office Visit - New Patient, Low Complexity | $268 | N/A | $268 |
| Office Visit - New Patient, Minor | $205 | N/A | $205 |
| Urine Test - Pregnancy | $37 | N/A | $37 |
| Urine Test - Urinalysis, Manual Test | $16 | N/A | $16 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $53 | N/A | $53 |
