Clinic
Upper Valley Community Health Services INC
Upper Valley Community Health Services INC was paid $4.88M by Medicaid between Jan 2018 and Oct 2024, across 30 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoUPPER VALLEY COMMUNITY HEALTH SERVICES INC
SAINT ANTHONY, ID 83445
SAINT ANTHONY, ID 83445
33aNPI1972792489assigned 10/20/2007
33bProvider typeUrgent Care Clinic/Center
28Total paid$4.88M
24GClaims60,068
24DCodes billed30
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in Idaho
Rank by total paid#2 of 16
Median peer was paid$394K
This provider vs. median12×
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 | 3,824 | $291K | |
| 2019 | 4,680 | $379K | |
| 2020 | 6,127 | $494K | |
| 2021 | 7,267 | $644K | |
| 2022 | 14,341 | $1.39M | |
| 2023 | 11,161 | $1.05M | |
| 2024incomplete | 12,668 | $629K |
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 | 99% | 25,951 | 21,485 | $4.82M |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 435 | 302 | $27K |
| 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% | 15,269 | 13,620 | $22K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,549 | 1,393 | $3K |
| 80053 | Comprehensive metabolic panel | <1% | 1,394 | 1,339 | $2K |
| 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 | <1% | 2,040 | 1,877 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 217 | 210 | $1K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,169 | 1,108 | $1K |
| 0012A | <1% | 16 | 16 | $322.08 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 93 | 92 | $217.46 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 39 | 39 | $108.72 |
| 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 | 26 | $22.32 |
18 more codes
| 90686 | <1% | 27 | $19.37 | |
| 81002 | <1% | 27 | $5.25 | |
| 1160F | 0% | 2,598 | $0.00 | |
| 90461 | 0% | 36 | $0.00 | |
| 1159F | 0% | 2,598 | $0.00 | |
| 81003 | 0% | 12 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 160 | $0.00 |
| 90791 | Psychiatric diagnostic evaluation | 0% | 144 | $0.00 |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 1,140 | $0.00 |
| H0031 | Mental health assessment, by non-physician | 0% | 116 | $0.00 |
| 3078F | 0% | 978 | $0.00 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 119 | $0.00 |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 0% | 117 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 26 | $0.00 |
| 3074F | 0% | 1,591 | $0.00 | |
| 3079F | 0% | 411 | $0.00 | |
| 3075F | 0% | 51 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 1,718 | $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 officialSESSIONS, LORI (CEO)
| Provider | Location | Paid |
|---|---|---|
| Upper Valley Community Health Services INC | Rexburg, ID | $7.64M |
| 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.