Physician
Family Medicine
Family Medicine
DODGEVILLE, WI
SSM HEALTH ST MARY'S HOSPITAL - MADISON
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 |
|---|---|---|---|---|
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $1,211 | $124 | $124 | 121 |
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | $1,131 | $282 | $282 | 18 |
99215 Established patient office or other outpatient visit, 40-54 minutes | $471 | $171 | $116 | 13 |
99214 Established patient office or other outpatient visit, 30-39 minutes | $335 | $122 | $71 | 246 |
91320 Sarscv2 vac 30mcg trs-suc im | $288 | $128 | $128 | 34 |
93000 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $243 | $14 | $10 | 21 |
99213 Established patient office or other outpatient visit, 20-29 minutes | $236 | $86 | $45 | 92 |
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | $163 | $76 | $76 | 37 |
69209 Removal of impacted ear wax by washing | $146 | $18 | $11 | 14 |
90480 Admn sarscov2 vacc 1 dose | $90 | $39 | $39 | 34 |
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $87 | $8 | $8 | 52 |
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $81 | $6 | $6 | 26 |
G0008 Administration of influenza virus vaccine | $53 | $29 | $29 | 43 |
G0009 Administration of pneumococcal vaccine | $53 | $29 | $29 | 19 |
36415 Insertion of needle into vein for collection of blood sample | $40 | $8 | $8 | 338 |
81003 Automated urinalysis test | $36 | $2 | $2 | 25 |
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Physician identity data from the NPPES NPI Registry. Last synced 3/28/2026.