| Office Visit - Basic | $87 | 0% | $87 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $184 | 0% | $184 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $200 | 0% | $200 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $204 | 0% | $204 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $217 | 0% | $217 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $182 | 0% | $182 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $171 | 0% | $171 |
| Office Visit - Established Patient, Low Complexity | $135 | 0% | $135 |
| Office Visit - Established Patient, Moderate Complexity | $198 | 0% | $198 |
| Office Visit - New Patient, Low Complexity | $186 | 0% | $186 |
| Office Visit - New Patient, Minor | $105 | 0% | $105 |
| Office Visit - New Patient, Moderate Complexity | $284 | 0% | $284 |
