| Object | # subjects | Frequency | Cost | Total | |
| Code | |||||
| 7320 | Laboratory/Medical Supplies and Service | ||||
| 35 - Investigational Drug Service - set up/admin year 1 | $600.00 | ||||
| 35 - Investigational Drug Service - set up/admin year 2 | $300.00 | ||||
| 35 - IDS- Dispensing fees -year 1 | 15 | 26 | $20.00 | $7,800.00 | |
| 35 - IDS- Dispensing fees -year 2 | 15 | 13 | $20.80 | $4,056.00 | |
| 35 - Lab venipuncture year 1 | 15 | 26 | $7.00 | $2,730.00 | |
| 35 - Lab venipuncture year 2 | 15 | 13 | $7.28 | $1,419.60 | |
| 35 - CBC and diff year 1 | 15 | 13 | $8.56 | $1,669.20 | |
| 35 - CBC and diff year 2 | 15 | 13 | $8.90 | $1,735.97 | |
| 35 - Comp. metabolic panel year 1 | 15 | 2 | $8.94 | $268.20 | |
| 35 - Comp. metabolic panel year 2 | 15 | 2 | $9.30 | $278.93 | |
| 35 - ECG | 15 | 1 | $40.99 | $614.85 | |
| 7450 | Hospital Outpatient | ||||
| 00 - DEXA, hip, pelvis | 15 | 2 | $108.60 | $3,258.00 | |
| 00 - Medicine Clinic Level 2 - new pt | 15 | 1 | $45.40 | $681.00 | |
| 00 - Medicine Clinic Level 1 - established pt year 1 | 15 | 25 | $24.15 | $9,056.25 | |
| 00 - Medicine Clinic Level 1 - established pt year 2 | 15 | 13 | $25.12 | $4,897.62 | |
| Total Cost of Fairview Services | $39,365.62 |