Clinic
Fall River Medical, PLLC
Fall River Medical, PLLC was paid $1.73M by Medicaid between Jan 2018 and Dec 2024, across 30 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 69% of everything it billed.
33Billing provider infoFALL RIVER MEDICAL, PLLC
REXBURG, ID 83440
REXBURG, ID 83440
33aNPI1457698987assigned 01/03/2013
33bProvider typeClinic/Center
28Total paid$1.73M
24GClaims31,278
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinic/Center providers in Idaho
Rank by total paid#3 of 25
Median peer was paid$248K
This provider vs. median7.0×
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 | 3,326 | $172K | |
| 2019 | 3,646 | $171K | |
| 2020 | 4,174 | $212K | |
| 2021 | 5,986 | $312K | |
| 2022 | 6,045 | $348K | |
| 2023 | 4,332 | $276K | |
| 2024incomplete | 3,769 | $242K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 69% | 20,519 | 18,800 | $1.19M |
| 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 | 13% | 2,576 | 2,366 | $222K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 4.9% | 1,152 | 1,147 | $85K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 3.2% | 1,042 | 992 | $55K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.4% | 984 | 964 | $42K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 1.7% | 702 | 647 | $30K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.5% | 297 | 259 | $26K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.3% | 214 | 214 | $22K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 105 | 105 | $12K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 536 | 405 | $11K |
| 90461 | <1% | 259 | 255 | $10K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 352 | 301 | $7K |
18 more codes
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 66 | $7K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,198 | $4K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 121 | $2K |
| 90686 | <1% | 282 | $2K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 98 | $1K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 120 | $964.72 |
| 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% | 51 | $877.12 |
| 81003 | <1% | 341 | $726.47 | |
| 80053 | Comprehensive metabolic panel | <1% | 55 | $552.86 |
| 0001A | <1% | 12 | $480.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 25 | $435.03 |
| 0011A | <1% | 17 | $413.04 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 55 | $409.14 |
| 80061 | Lipid panel | <1% | 14 | $170.19 |
| 90677 | <1% | 25 | $0.03 | |
| 90647 | 0% | 13 | $0.00 | |
| 91301 | 0% | 14 | $0.00 | |
| 91300 | 0% | 33 | $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 officialGILLETTE, AUSTIN (OWNER)