Upstate Family and Preventive Medicine, INC

Upstate Family and Preventive Medicine, INC was paid $960K by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 50% of everything it billed.

33Billing provider infoUPSTATE FAMILY AND PREVENTIVE MEDICINE, INC
SYRACUSE, NY 13210

33aNPI1073988911assigned 12/03/2015

33bProvider typeFamily Medicine Physician

28Total paid$960K

24GClaims28,514

24DCodes billed15

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Family Medicine Physician providers in New York

Rank by total paid#127 of 2,605

Median peer was paid$10K

This provider vs. median95×

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	1,176	$78K
2019	2,307	$88K
2020	4,197	$95K
2021	5,733	$165K
2022	3,085	$156K
2023	6,974	$215K
2024incomplete	5,042	$162K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	50%	11,343	10,939	$480K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	47%	15,118	14,130	$448K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	167	167	$9K
90460	Immunization administration through 18 years of age via any route, first or only component	<1%	430	425	$7K
90686		<1%	508	506	$6K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	449	447	$3K
90674		<1%	73	73	$2K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	98	93	$2K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	<1%	26	26	$1K
0031A		<1%	33	33	$1K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	27	27	$796.29
99238	Hospital discharge day management, 30 minutes or less	<1%	24	24	$787.60

3 more codes

0001A		<1%	14	$468.10
90656		<1%	26	$368.80
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)	<1%	178	$308.27

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 officialEPLING, JOHN (CHAIRMAN)