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    OpenPayerNPI Medicare & MedicaidUpper Valley Family Medicine PLLC
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    Upper Valley Family Medicine PLLC — Billing Profile & Reimbursement Data

    NPI 1073697884 · Rigby, ID · Family Medicine Physician

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    Upper Valley Family Medicine PLLC is a family medicine physician provider located in Rigby, Idaho. This profile covers 0 Medicare and 25 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationUpper Valley Family Medicine PLLC
    Address711 Rigby Lake Dr Ste 115
    CityRigby
    StateID
    ZIP83442
    TaxonomyFamily Medicine Physician
    NPI EnumeratedOctober 25, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$1.9M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    25 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive15,770$90$1.5M
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…21,140$10$274.8K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…3,260$40$137K
    87502The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…210$60$13.4K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…1,880$10$9.4K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.550$20$8.2K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.3,230$1$6.5K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.80$80$6.2K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.40$100$3.9K
    99395The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.40$90$3.5K

    Showing 1–10 of 25

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Idaho median

    25 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive371405,470$180$2.6M
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…26670740$40$193.6K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…114620560$60$191.8K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.4780130$80$91.4K
    87502The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…2450210$80$51.4K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.57702,170$10$42.9K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.346050$70$35.5K
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.6870240$20$34.3K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…5250940$10$34.2K
    87651The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.2040150$30$30.8K

    Showing 1–10 of 25

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Upper Valley Family Medicine PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mountain View Hospital LLCIDGeneral Acute Care Hospital$0$45.7M
    Wenshu YuUTRheumatology Physician$396.3K$0
    James BlaineIDMedical Physician Assistant$297.2K$0
    Terry BakerIDOtolaryngology Physician$74.8K$181.8K
    John ChambersIDCardiovascular Disease Physician$239K$0
    Patrick GormanIDCardiovascular Disease Physician$236.3K$0
    Scott CooleAZPulmonary Disease Physician$193.8K$0
    Aaron AltenburgIDOrthopaedic Surgery Physician$189.7K$0
    Katie RyderFLCardiovascular Disease Physician$189.2K$0
    Brett HiendlmayrWAInterventional Cardiology Physician$188.7K$0

    Nearby Providers

    Other providers in the same ZIP code as Upper Valley Family Medicine PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Van Wagoner Consulting, Inc.IDCase Management Agency$0$6.7M
    Jefferson Joint School District 251IDLocal Education Agency (LEA)$0$3.5M
    Robert EllisIDDentist$0$1.3M
    West Wind DentalIDGeneral Practice Dentistry$0$644.9K
    Rigby Pediatric Dental PLLCIDPediatric Dentistry$0$576.5K
    Stephen RichinsIDMedical Physician Assistant$466.6K$0
    Mobley Physical Therapy PCIDPhysical Therapy Clinic/Center$0$444.8K
    Rigby Physical Therapy, PLLCIDPhysical Therapist$0$363.1K
    Cameron FrenchIDMedical Physician Assistant$173.9K$0
    Kay BishopIDSpecialist$152.2K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Idaho Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Idaho Distribution
    Upper Valley Family Medicine PLLC — 1 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Idaho