| Office Visit - Basic | $95 | 0% | $95 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $278 | 0% | $278 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $221 | 0% | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $226 | 0% | $226 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $194 | 0% | $194 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $168 | 0% | $168 |
| Office Visit - Established Patient, Low Complexity | $147 | 0% | $147 |
| Office Visit - Established Patient, Moderate Complexity | $215 | 0% | $215 |
| Office Visit - New Patient, Low Complexity | $215 | 0% | $215 |
| Office Visit - New Patient, Minor | $152 | 0% | $152 |
| Strep Test (Streptococcus, group A) | $79 | 0% | $79 |
| Urine Test - Pregnancy | $21 | 0% | $21 |
| Urine Test - Urinalysis, Manual Test | $21 | 0% | $21 |
