Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Idaho for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Idaho only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Idaho (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Upper Valley Community Health Services Inc (NPI 1053770230)

Field	Value
Entity Type	Organization
Organization	Upper Valley Community Health Services Inc
Address	325 E Main St
City	Saint Anthony
State	ID
ZIP	83445
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 17, 2016

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0999	N/A	7,690	$260	$2M
D0140	Limited oral evaluation – problem focused	310	$1	$310
D0120	Periodic oral evaluation - established patient	980	$0	$0
D0150	Comprehensive oral evaluation – new or established patient	810	$0	$0
D0220	Intraoral - periapical first radiographic image	2,780	$0	$0
D0230	Intraoral - periapical each additional radiographic image	4,430	$0	$0
D0274	N/A	1,380	$0	$0
D0330	N/A	720	$0	$0
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	990	$0	$0
D1120	Prophylaxis–child	70	$0	$0

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.

Claims Volume vs. Idaho Distribution

Upper Valley Community Health Services Inc — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	8	30	3,960	$250	$1.5M
D1120	Prophylaxis–child	162	250	180	$60	$143K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	83	320	310	$80	$80.8K
D2392	Post 2 surface resin‑based composite	66	190	280	$60	$72.9K
D2393	Resin-based composite, three surfaces, posterior	65	70	140	$120	$41.6K
D0330	N/A	46	170	170	$50	$35.6K
D2391	Resin‑based composite – one surface, posterior	112	140	270	$40	$27.9K
D0150	Comprehensive oral evaluation – new or established patient	56	220	220	$30	$21.2K
D0140	Limited oral evaluation – problem focused	81	200	190	$20	$10.7K
D0274	N/A	52	260	240	$10	$7.3K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Upper Valley Community Health Services Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Excellence In Everyone, LLC	ID	Developmental Disabilities Clinic/Center	$0	$5.2M
Upper Valley Community Health Services Inc	ID	Federally Qualified Health Center (FQHC)	$0	$4.9M
Fremont Joint School District #215	ID	Local Education Agency (LEA)	$0	$511.3K
County Of Fremont	ID	Land Ambulance	$125.2K	$84.4K
Bryce Woodfield	ID	Physical Therapist	$176.9K	$0
Brett Zundel	ID	Medical Physician Assistant	$158K	$0
Ryan Willmore	ID	Physician Assistant	$530	$0

Upper Valley Community Health Services Inc — Billing Profile & Reimbursement Data

Sign up for Upper Valley Community Health Services Inc — Billing Profile & Reimbursement Data policy alerts

Upper Valley Community Health Services Inc — Billing Profile & Reimbursement Data

Sign up for Upper Valley Community Health Services Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References