Physician
Family Medicine
Family Medicine
SALT LAKE CITY, UT
INTERMOUNTAIN MEDICAL CENTER
intermountainhealthcare.org/locations/intermountain-medical-center
INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL
Based on specialty. Actual services may vary — contact the provider's office to confirm.
Based on CMS Medicare Provider Utilization data for 2023. These represent what this physician charged Medicare, not necessarily what you would pay. Compare with other physicians
| Procedure | Avg Charge | Medicare Allowed | Medicare Paid | Services |
|---|---|---|---|---|
91320 Sarscv2 vac 30mcg trs-suc im | $295 | $117 | $117 | 23 |
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | $283 | $274 | $274 | 13 |
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $200 | $120 | $120 | 90 |
99214 Established patient office or other outpatient visit, 30-39 minutes | $165 | $118 | $71 | 198 |
99213 Established patient office or other outpatient visit, 20-29 minutes | $105 | $83 | $46 | 118 |
G0103 Prostate cancer screening; prostate specific antigen test (psa) | $83 | $19 | $19 | 11 |
84153 Psa (prostate specific antigen) measurement, total | $83 | $18 | $18 | 18 |
90662 Influenza vaccine split virus, preservative free | $80 | $68 | $68 | 35 |
84443 Blood test, thyroid stimulating hormone (tsh) | $78 | $16 | $16 | 41 |
80061 Blood test, lipids (cholesterol and triglycerides) | $74 | $13 | $13 | 92 |
80053 Blood test, comprehensive group of blood chemicals | $48 | $10 | $10 | 103 |
90480 Admn sarscov2 vacc 1 dose | $40 | $36 | $36 | 23 |
80048 Blood test, basic group of blood chemicals (calcium, total) | $34 | $8 | $8 | 21 |
G0009 Administration of pneumococcal vaccine | $32 | $29 | $29 | 13 |
G0008 Administration of influenza virus vaccine | $32 | $27 | $27 | 39 |
83036 Hemoglobin a1c level | $26 | $9 | $9 | 65 |
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $25 | $7 | $7 | 70 |
36415 Insertion of needle into vein for collection of blood sample | $20 | $8 | $8 | 52 |
81001 Manual urinalysis test with examination using microscope, automated | $17 | $3 | $3 | 26 |
84550 Uric acid level, blood | $13 | $4 | $4 | 16 |
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Physician identity data from the NPPES NPI Registry. Last synced 3/28/2026.