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NPI 1699774646 · Lawrence, MA · Federally Qualified Health Center (FQHC)
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Greater Lawrence Family Health Center, Inc. is a federally qualified health center (fqhc) provider located in Lawrence, Massachusetts. This profile covers 0 Medicare and 141 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Greater Lawrence Family Health Center, Inc. |
| Address | 34 Haverhill St |
| City | Lawrence |
| State | MA |
| ZIP | 01841 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | July 20, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $103.8M |
| Medicare | $0 |
This provider is effectively Medicaid-focused: there is no Medicare billing on file and total Medicaid revenue is $103.8M, so the organization operates as a single-payer (Medicaid) revenue center at scale rather than a dual-payer practice. The NPI was enumerated on 2005-07-20 (~21 years ago), indicating long-standing presence in the community.
Revenue is highly concentrated in a few FQHC encounter codes: the top 3 Medicaid codes by revenue account for 87.5% of this provider's total Medicaid revenue, and T1015 alone generates $85.9M (84.4% of Medicaid revenue). This concentration signals that per‑encounter, all‑inclusive clinic visits are the dominant business line and primary driver of Medicaid inflows.
The code mix is consistent with a full-service Federally Qualified Health Center model: dominant use of T1015 (clinic visit/encounter, all‑inclusive) plus G0467 (FQHC visit, established patient, $1.7M, 1.7%) and G0470 (FQHC mental health visit, $1.5M, 1.4%) shows bundled per‑diem primary care encounters combined with integrated behavioral health services. The presence of G0470 indicates an embedded mental‑health service line, though its volume is typical rather than extreme.
Competitive standing within Massachusetts is pronounced for FQHC encounter billing: T1015 ranks #1 of 553 providers in-state (100th percentile; extreme outlier) and G0467 ranks #1 of 109 providers (100th percentile; extreme outlier), meaning this center bills far above typical state volume for core FQHC visit codes and likely captures substantial share of Medicaid FQHC encounter volume in its region. G0470 is at the 79th percentile (rank #17 of 77) and is therefore unremarkable by comparison.
The practice also reports meaningful obstetric and newborn activity: 59400 ($1.4M, 635 claims) and 59510 ($1.3M, 534 claims) each represent ~1.3% of Medicaid revenue and rank #3 of 21 (90th percentile) and #1 of 7 (100th percentile) respectively. These placements indicate the center is a notable provider of prenatal and delivery services among in‑state Medicaid providers, contributing a material but minority share of total revenue.
Preventive, pediatric, and immunization services are high‑volume components of care: 99391 ($1.1M), 99392 ($1.1M), 99393 ($945.7K) and vaccine administration 90471 ($380.3K) all sit at or above the 96th–98th percentiles for in‑state providers, demonstrating elevated throughput for well‑child and preventive visits that aligns with a community health center serving a pediatric population. This pattern supports a broad primary‑care and population‑health orientation.
Operational and screening activity is unusually large in several non‑E/M codes: 99050 (after‑hours office services) has 25.4K claims and $964K (rank #2 of 181, 99th percentile; extreme outlier), and 96110 (developmental screening) has 29.2K claims and $292.1K (rank #17 of 1137, 99th percentile; extreme outlier). Together these indicate high visit volume, frequent after‑hours access or documentation of off‑schedule services, and a systematic approach to pediatric developmental screening.
While some high-dollar items (for example J3490, $584.7K) appear in the top 25, their ranks are typical or mixed; overall the provider’s Medicaid profile is dominated by bundled FQHC encounter billing and high volumes of primary care, preventive, pediatric, and some behavioral‑health services rather than substantial fee‑for‑service specialty or Medicare-based revenue streams.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
141 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 547,450 | $160 | $85.9M |
| 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… | 80,690 | $20 | $1.7M |
| 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… | 7,810 | $190 | $1.5M |
| 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… | 640 | $2,160 | $1.4M |
| 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… | 530 | $2,390 | $1.3M |
| 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… | 8,970 | $130 | $1.1M |
| 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… | 7,670 | $140 | $1.1M |
| 99050 | In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed. | 25,370 | $40 | $964K |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 6,840 | $140 | $957.2K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 6,710 | $140 | $945.7K |
Showing 1–10 of 141
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
141 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 41 | 170 | 950 | $200 | $1.8M |
| T1015 | Clinic visit/encounter, all-inclusive | 1 | 550 | 90 | $140 | $1.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 226 | 240 | 980 | $180 | $1.2M |
| 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… | 17 | 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. | 186 | 410 | 140 | $110 | $742.2K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 210 | 220 | 1,290 | $180 | $740.6K |
| 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… | 280 | 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… | 3 | 20 | 70 | $2,130 | $586.8K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | 20 | 20 | 480 | $640 | $583.9K |
| 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… | 1 | 10 | 70 | $2,410 | $428.5K |
Showing 1–10 of 141
Other providers in the same ZIP code as Greater Lawrence Family Health Center, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Lawrence General Hospital | MA | General Acute Care Hospital | $0 | $84.6M |
| Lawrence General Hospital | MA | Land Ambulance | $925.5K | $10M |
| Dental Dreams, LLC | MA | General Practice Dentistry | $0 | $6.1M |
| Merrimack Valley Health Services Inc | MA | Magnetic Resonance Imaging (MRI) Clinic/Center | $79.9K | $1.3M |
| Drasko Simovic | MA | Clinical Neurophysiology Physician | $258.4K | $661.1K |
| Amin Paulino | MA | Nephrology Physician | $205.5K | $0 |
| Michael Landman | MA | Nephrology Physician | $197.1K | $0 |
| Jose Baez | MA | Internal Medicine Physician | $127.2K | $59.6K |
| Torkom Garabedian | MA | Internal Medicine Physician | $153K | $0 |
| Ronald Garrell | MA | Diagnostic Radiology Physician | $147.6K | $850 |
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