| Office Visit - Basic | $89 | N/A | $89 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $318 | N/A | $318 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $370 | N/A | $370 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $287 | N/A | $287 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $292 | N/A | $292 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $312 | N/A | $312 |
| Office Visit - Established Patient, High Complexity | $292 | N/A | $292 |
| Office Visit - Established Patient, Low Complexity | $129 | N/A | $129 |
| Office Visit - Established Patient, Moderate Complexity | $268 | N/A | $268 |
| Office Visit - New Patient, Low Complexity | $270 | N/A | $270 |
| Office Visit - New Patient, Minor | $186 | N/A | $186 |
| Office Visit - New Patient, Moderate Complexity | $408 | N/A | $408 |
| Vaccine - Influenza for Injection into Muscle | $36 | N/A | $36 |
