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    Thyroxine (T4) Total
    1 X $30.00 = $30.00
    Varicella Zoster Virus Ab., IgG
    1 X $40.00 = $40.00
    Sodium
    1 X $18.00 = $18.00
    C-Reactive Protein (CRP)
    1 X $31.00 = $31.00
    Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)
    1 X $45.00 = $45.00
    RPR W/ Reflex to (1357 Syphilis & 337 RPR Titer)
    2 X $48.00 = $96.00
    Subtotal $260.00
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