| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $289 | N/A | $289 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $289 | N/A | $289 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $284 | N/A | $284 |
| 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 | $263 | N/A | $263 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $299 | N/A | $299 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $260 | N/A | $260 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $210 | N/A | $210 |
| Office Visit - Established Patient, Low Complexity | $147 | N/A | $147 |
| Office Visit - Established Patient, Moderate Complexity | $226 | N/A | $226 |
| Office Visit - New Patient, Low Complexity | $221 | N/A | $221 |
| Office Visit - New Patient, Moderate Complexity | $336 | N/A | $336 |
| Vaccine - Influenza for Injection into Muscle | $53 | N/A | $53 |
