| Office Visit - Basic | $99 | 0% | $99 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $327 | 0% | $327 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $284 | 0% | $284 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $284 | 0% | $284 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $301 | 0% | $301 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $253 | 0% | $253 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $242 | 0% | $242 |
| Office Visit - Established Patient, Low Complexity | $158 | 0% | $158 |
| Office Visit - Established Patient, Moderate Complexity | $233 | 0% | $233 |
| Office Visit - New Patient, Low Complexity | $234 | 0% | $234 |
| Office Visit - New Patient, Minor | $163 | 0% | $163 |
