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.

South Cove Community Health Center, Inc. (NPI 1700801263)

Field	Value
Entity Type	Organization
Organization	South Cove Community Health Center, Inc.
Address	885 Washington St
City	Boston
State	MA
ZIP	02111
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 13, 2006

Payer Source	Total Paid
Medicaid	$20.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

143 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	126,030	$50	$6.2M
D9450	N/A	73,030	$30	$2.5M
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…	7,290	$190	$1.4M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	30,580	$30	$1M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	105,380	$10	$737.7K
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…	69,770	$10	$697.7K
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…	20,170	$30	$685.6K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	20,650	$30	$578.3K
D0120	Periodic oral evaluation - established patient	33,160	$20	$530.5K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	7,050	$70	$521.9K

Showing 1–10 of 143

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

South Cove Community Health Center, Inc. — 13 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

143 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1040	Medicaid certified community behavioral health clinic services, per diem	64	170	950	$200	$1.8M
T1015	Clinic visit/encounter, all-inclusive	15	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…	18	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.	87	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…	503	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…	18	20	70	$2,130	$586.8K
D9450	N/A	13	150	2,450	$30	$506.8K
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…	11	110	3,490	$40	$309.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	5	950	90	$100	$212.9K
99214	The 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…	862	5,040	200	$70	$209.5K

Showing 1–10 of 143

Related Providers

Other providers that share a Tax Identification Number (TIN) with South Cove Community Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maddie Hao	MA	Pediatrics Physician	$0	$7.7M
Minping Liu	MA	Internal Medicine Physician	$14.7K	$6.6M

Nearby Providers

Other providers in the same ZIP code as South Cove Community Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tufts Medical Center, Inc.	MA	General Acute Care Hospital	$0	$164.6M
Boston Senior Home Care	MA	Case Management Agency	$0	$118.8M
Boston Senior Home Care	MA	Case Management Agency	$0	$38.9M
Trustees Of Tufts College	MA	Dental Clinic/Center	$0	$18.2M
Pratt Pediatric Associates Inc	MA	Pediatrics Physician	$0	$7.7M
Boston Center For Independent Living, Inc.	MA	Personal Care Attendant	$0	$7.2M
Tufts Medical Center Ep LLC	MA	Emergency Medicine Physician	$0	$6.6M
Andre Witkin	MA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Michelle Liang	MA	Ophthalmology Physician	$2.1M	$0
Pet-ct Services By Tufts Medical Center And Shields LLC	MA	Mobile Radiology Clinic/Center	$779.1K	$1.2M

South Cove Community Health Center, Inc. — Billing Profile & Reimbursement Data

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South Cove Community Health Center, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References