Upper Valley Family Medicine PLLC

Upper Valley Family Medicine PLLC was paid $1.92M by Medicaid between Jan 2018 and Dec 2024, across 25 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 76% of everything it billed.

33Billing provider infoUPPER VALLEY FAMILY MEDICINE PLLC
RIGBY, ID 83442

33aNPI1073697884assigned 10/25/2006

33bProvider typeFamily Medicine Physician

28Total paid$1.92M

24GClaims47,764

24DCodes billed25

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Family Medicine Physician providers in Idaho

Rank by total paid#14 of 136

Median peer was paid$139K

This provider vs. median14×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	8,011	$274K
2019	6,303	$241K
2020	6,216	$260K
2021	7,939	$312K
2022	8,665	$359K
2023	5,964	$260K
2024incomplete	4,666	$209K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	76%	15,766	14,962	$1.45M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	14%	21,142	19,504	$273K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	7.1%	3,262	2,941	$136K
87502	Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets	<1%	210	197	$13K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	1,879	1,764	$9K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	549	507	$8K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	75	71	$6K
36415	Collection of venous blood by venipuncture	<1%	3,225	2,958	$6K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	41	41	$4K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	39	39	$3K
87651	Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe	<1%	152	146	$3K
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	279	239	$2K

13 more codes

83037		<1%	233	$2K
80053	Comprehensive metabolic panel	<1%	169	$1K
90472	Immunization administration, each additional vaccine (list separately)	<1%	14	$326.16
90686		<1%	72	$262.74
81001		<1%	133	$170.46
84443	Thyroid stimulating hormone (TSH)	<1%	12	$166.32
90756		<1%	39	$126.26
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	<1%	319	$19.34
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	17	$4.04
90655		<1%	31	$0.05
G8783	Normal blood pressure reading documented, follow-up not required	0%	23	$0.00
1036F		0%	64	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	0%	19	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialBERRETT, DARIN (OFFICE MANAGER)