An established patient was seen in the office today by Dr. Frank to discuss a weight loss plan that she started six months ago and why she hasn't lost any weight. The physician completed a medically necessary history and exam and high-level MDM, where he spent 45 minutes with the patient to assess her obesity and lifestyle, and to discuss changes needed to decrease her weight to a healthy level. The physician ordered some labs and a stress test, discussed health risks, and referred her to a dietician. The patient will return in three months to follow up with her progress and for re-evaluation. What is the correct E/M code for these services?