East Falls Family Medicine, LLC
East Falls Family Medicine, LLC was paid $1.05M by Medicaid between Jan 2018 and Dec 2024, across 16 billing codes. Its largest line is 99222, Initial hospital care, per day, moderate complexity — 29% of everything it billed.
IDAHO FALLS, ID 83404
Next to other Family Medicine Physician providers in Idaho
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,563 | $111K | |
| 2019 | 1,932 | $100K | |
| 2020 | 3,599 | $196K | |
| 2021 | 3,329 | $189K | |
| 2022 | 3,166 | $198K | |
| 2023 | 2,389 | $155K | |
| 2024incomplete | 1,700 | $105K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99222 | Initial hospital care, per day, moderate complexity | 29% | 3,308 | 3,144 | $307K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29% | 5,697 | 5,153 | $302K |
| 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 | 24% | 3,616 | 3,266 | $255K |
| 99221 | 6.5% | 975 | 962 | $68K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 5.0% | 1,064 | 789 | $53K |
| 99223 | Prolong inpt eval add15 m | 3.7% | 269 | 256 | $39K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.9% | 722 | 584 | $20K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,381 | 1,320 | $4K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 178 | 173 | $3K |
| 90686 | <1% | 170 | 165 | $2K | |
| 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% | 15 | 15 | $1K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | <1% | 12 | 12 | $817.11 |
4 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 28 | $203.20 |
| G8430 | Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status) | 0% | 162 | $0.00 |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 237 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 844 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.