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 Massachusetts for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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.

Brockton Neighborhood Health Center (NPI 1225085319)

Field	Value
Entity Type	Organization
Organization	Brockton Neighborhood Health Center
Address	63 Main St
City	Brockton
State	MA
ZIP	02301
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$91.2M
Medicare	$0

Key Findings

BROCKTON NEIGHBORHOOD HEALTH CENTER is effectively single‑payer in scale: it reports $91.2M in lifetime Medicaid revenue and has no Medicare billing on file. Its NPI was enumerated on 2006-05-27 (~20 years ago), indicating long-standing participation in Medicaid and community health programs.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top three Medicaid codes account for 78.4% of the provider's total Medicaid revenue, led overwhelmingly by T1015 which alone generates $56.4M (70.1% of Medicaid revenue). The other two top drivers are 59400 ($4M; 5.0%) and D9450 ($2.7M; 3.3%), illustrating a narrow set of services that produce most receipts.

The overall code mix and the presence of FQHC‑specific billing indicate the center functions primarily as a high‑volume community health clinic: T1015 (378.7K claims, $149 avg paid/claim) and the FQHC visit code G0467 (39.5K claims, $32 avg paid/claim) together show bundled, per‑encounter FQHC billing is the dominant operational model. Preventive medicine codes (99391, 99392, 99393, 99395, 99394) and high vaccination volumes (90460: 41.3K claims; 90739: 3.3K claims) further signal a large pediatric and preventive care population served on a routine basis.

BROCKTON operates a substantial maternity service footprint: 59400 (1.9K claims, $2117 avg paid/claim, $4M revenue) ranks #1 of 21 providers in‑state (100th percentile; extreme outlier) and 59510 adds additional obstetric revenue ($880K). These rankings and claim volumes imply the center is a major local provider of global antepartum and delivery services within the Medicaid program.

Dental and oral health services are a meaningful secondary revenue stream: codes such as D9450 (116.6K claims, $23 avg paid/claim, $2.7M; ranks #6 of 150, 97th percentile), D0220 (36.1K claims, $9 avg paid/claim, $325.1K; ranks #5 of 1202, 100th percentile), D0140 and D9110 also appear with extreme or very high statewide ranks. The combination of large dental claim counts and multiple dental CPT/D codes suggests integrated dental clinics or co‑located dental services as part of the FQHC model.

Behavioral health and certified community services are present but not dominant: T1040 (7.7K claims, $131 avg paid/claim, $1M revenue) ranks #40 of 167 (77th percentile; typical) and G0470 (9K claims, $43 avg paid/claim, $388.6K) ranks #13 of 77 (84th percentile; typical). These volumes indicate routine provision of mental health/CBHC services within the center’s broader primary care and preventive portfolio rather than a primary specialty focus.

Across many codes the center is a statewide outlier or high‑percentile performer: T1015 is an extreme outlier in volume (ranks #4 of 553, 99th percentile), 59400 is an extreme outlier (ranks #1 of 21, 100th percentile), and preventive, vaccination, and several dental codes also sit in the 96th–100th percentiles. This pattern establishes the center as a dominant Medicaid provider in several service lines at the state level rather than a marginal participant.

The provider’s heavy dependence on a small set of high‑revenue codes (top 3 = 78.4% of Medicaid revenue) means operational and financial exposure is concentrated in FQHC bundled visits and obstetric/dental services. Any changes to Medicaid reimbursement for T1015, FQHC payment policy, or maternity/dental coverage could materially affect overall revenue given the current billing profile.

Medicaid: Complete Services Breakdown

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

271 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	378,690	$150	$56.4M
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	1,900	$2,120	$4M
D9450	N/A	116,640	$20	$2.7M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,570	$140	$2.4M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12,490	$130	$1.7M
99213	The 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…	51,160	$30	$1.5M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,960	$140	$1.3M
G0467	Federally 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…	39,500	$30	$1.3M
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	7,320	$160	$1.2M
T1040	Medicaid certified community behavioral health clinic services, per diem	7,740	$130	$1M

Showing 1–10 of 271

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Brockton Neighborhood Health Center — 21 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

271 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	40	170	950	$200	$1.8M
T1015	Clinic visit/encounter, all-inclusive	4	550	90	$140	$1.5M
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	13	80	1,720	$150	$800.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	51	410	140	$110	$742.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	187	1,620	580	$80	$599.6K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	1	20	70	$2,130	$586.8K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	6	20	480	$640	$583.9K
D9450	N/A	6	150	2,450	$30	$506.8K
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	2	10	70	$2,410	$428.5K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	6	120	200	$180	$352.7K

Showing 1–10 of 271

Related Providers

Other providers that share a Tax Identification Number (TIN) with Brockton Neighborhood Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brockton Neighborhood Health Center	MA	Federally Qualified Health Center (FQHC)	$0	$7.5M

Nearby Providers

Other providers in the same ZIP code as Brockton Neighborhood Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$309.8M
Old Colony Elderly Services, Inc.	MA	Case Management Agency	$0	$137.5M
South Bay Mental Health Center, Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$112M
Massachusetts Mentor LLC	MA	Foster Care Agency	$0	$95.6M
Sb Transitional Sub, LLC	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$84.8M
Steward Good Samaritan Medical Center, Inc.	MA	General Acute Care Hospital	$0	$64.2M
Pediatric Services Of America, LLC	MA	Nursing Care Agency	$0	$47.8M
South Bay Mental Health Center, Inc.	MA	Adolescent and Children Mental Health Clinic/Center	$0	$43.2M
Sb Transitional Sub, LLC	MA	Early Intervention Provider Agency	$0	$35.9M
Healthier You Wellness Nutrition Partners Of Greater Boston, LLC	MA	Health Maintenance Organization	$0	$33.8M

Brockton Neighborhood Health Center — Billing Profile & Reimbursement Data

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Brockton Neighborhood Health Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References