Clinic
Upper Valley Community Health Services INC
Upper Valley Community Health Services INC was paid $7.64M by Medicaid between Jan 2018 and Nov 2024, across 45 billing codes. Its largest line is D0999, Unspecified diagnostic procedure, by report — 55% of everything it billed.
33Billing provider infoUPPER VALLEY COMMUNITY HEALTH SERVICES INC
REXBURG, ID 83440
REXBURG, ID 83440
33aNPI1124403258assigned 07/30/2015
33bProvider typeUrgent Care Clinic/Center
28Total paid$7.64M
24GClaims98,750
24DCodes billed45
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in Idaho
Rank by total paid#1 of 16
Median peer was paid$394K
This provider vs. median19×
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 | 5,820 | $511K | |
| 2019 | 7,007 | $608K | |
| 2020 | 13,535 | $1.05M | |
| 2021 | 15,454 | $1.26M | |
| 2022 | 17,338 | $1.36M | |
| 2023 | 19,788 | $1.50M | |
| 2024incomplete | 19,808 | $1.36M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0999 | Unspecified diagnostic procedure, by report | 55% | 16,279 | 14,769 | $4.20M |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 45% | 18,481 | 15,669 | $3.42M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 11,270 | 9,417 | $16K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 823 | 820 | $3K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,307 | 1,214 | $1K |
| 90686 | <1% | 269 | 268 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 15 | 14 | $887.88 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 485 | 483 | $844.45 |
| G0008 | Administration of influenza virus vaccine | <1% | 158 | 157 | $812.70 |
| 80053 | Comprehensive metabolic panel | <1% | 943 | 929 | $748.91 |
| 0011A | <1% | 34 | 34 | $684.42 | |
| 81002 | <1% | 337 | 204 | $577.73 |
33 more codes
| 0012A | <1% | 27 | $523.38 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 610 | $389.50 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 839 | $38.58 |
| 80061 | Lipid panel | <1% | 44 | $33.27 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 94 | $27.74 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,124 | $1.47 |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 1,995 | $0.00 |
| D0120 | Dental checkup, returning patient | 0% | 3,398 | $0.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 11,116 | $0.00 |
| D0140 | Limited oral evaluation - problem focused | 0% | 648 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 2,565 | $0.00 |
| 3074F | 0% | 894 | $0.00 | |
| D7140 | Extraction, erupted tooth or exposed root | 0% | 203 | $0.00 |
| 3079F | 0% | 282 | $0.00 | |
| 3075F | 0% | 97 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 0% | 319 | $0.00 |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 0% | 44 | $0.00 |
| D0330 | Panoramic radiographic image | 0% | 2,438 | $0.00 |
| D0274 | Bitewings - four radiographic images | 0% | 3,965 | $0.00 |
| 3078F | 0% | 575 | $0.00 | |
| D1110 | Prophylaxis - adult | 0% | 3,711 | $0.00 |
| 1160F | 0% | 1,563 | $0.00 | |
| 1159F | 0% | 1,563 | $0.00 | |
| 90461 | 0% | 552 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 336 | $0.00 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 0% | 214 | $0.00 |
| 90670 | 0% | 13 | $0.00 | |
| 90671 | 0% | 25 | $0.00 | |
| D1120 | Dental cleaning, child | 0% | 25 | $0.00 |
| D4910 | 0% | 12 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 16 | $0.00 |
| D0220 | Intraoral - periapical first radiographic image | 0% | 6,346 | $-36.37 |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 2,696 | $-216.64 |
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 officialSESSIONS, LORI (CEO)
| Provider | Location | Paid |
|---|---|---|
| Upper Valley Community Health Services INC | Saint Anthony, ID | $4.88M |
| Upper Valley Community Health Services INC | Saint Anthony, ID | $1.98M |
| Upper Valley Community Health Services INC | Idaho Falls, ID | $17K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.