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    Iron, Total
    1 X $20.00 = $20.00
    Sm/RNP Abs
    1 X $51.50 = $51.50
    Partial Thromboplastin Time (PTT), Activated
    1 X $19.50 = $19.50
    Uric Acid, Serum
    1 X $18.00 = $18.00
    Vitamin B12
    1 X $23.00 = $23.00
    Mono Test (Epstein Barr Heterophile Ag IgM)
    1 X $32.50 = $32.50
    LDL Cholesterol, measured
    1 X $20.00 = $20.00
    Potassium, Plasma
    1 X $21.50 = $21.50
    Hepatic Function Panel
    1 X $20.00 = $20.00
    Deamidated Gliadin Peptide IgA
    1 X $41.50 = $41.50
    Subtotal $267.50
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