Agency
Blackstone Valley Community Health Care, INC.
Blackstone Valley Community Health Care, INC. was paid $12.38M by Medicaid between Jan 2018 and Dec 2024, across 76 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoBLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC.
PAWTUCKET, RI 02860
PAWTUCKET, RI 02860
33aNPI1063574135assigned 12/15/2006
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$12.38M
24GClaims294,534
24DCodes billed76
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Rhode Island
Rank by total paid#8 of 51
Median peer was paid$731K
This provider vs. median17×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 50,328 | $1.86M | |
| 2019 | 44,867 | $1.64M | |
| 2020 | 31,680 | $1.13M | |
| 2021 | 46,445 | $1.80M | |
| 2022 | 43,678 | $2.08M | |
| 2023 | 38,649 | $1.96M | |
| 2024incomplete | 38,887 | $1.93M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 35% | 93,890 | 82,405 | $4.29M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 22% | 42,970 | 37,195 | $2.72M |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 7.7% | 7,682 | 7,432 | $955K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 5.4% | 10,774 | 8,446 | $674K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 4.3% | 12,315 | 9,482 | $537K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 2.7% | 7,928 | 6,240 | $339K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.6% | 4,941 | 4,357 | $318K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.3% | 4,529 | 4,008 | $287K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.1% | 8,249 | 7,472 | $266K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.0% | 3,800 | 3,269 | $251K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 1.8% | 29,120 | 25,289 | $226K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 1.4% | 4,236 | 4,007 | $169K |
64 more codes
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.3% | 10,931 | $162K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.3% | 2,175 | $158K |
| 99215 | Doctor's office visit, returning patient (complex) | 1.1% | 1,371 | $132K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 6,645 | $87K |
| 92015 | Determination of refractive state | <1% | 3,491 | $72K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | <1% | 41 | $69K |
| 90837 | Psychotherapy session, about an hour | <1% | 824 | $68K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 5,560 | $53K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 4,259 | $47K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,202 | $46K |
| V2020 | Frames, purchases | <1% | 889 | $41K |
| 82962 | <1% | 5,463 | $37K | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 1,805 | $32K |
| 99442 | <1% | 1,110 | $30K | |
| 0012A | <1% | 874 | $26K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 485 | $24K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,623 | $24K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,192 | $22K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 827 | $19K |
| 87428 | <1% | 303 | $19K | |
| 0011A | <1% | 905 | $17K | |
| 0002A | <1% | 365 | $15K | |
| 92250 | <1% | 419 | $12K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 525 | $10K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 544 | $9K |
| 81025 | <1% | 1,965 | $9K | |
| 0001A | <1% | 223 | $9K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 140 | $8K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 140 | $8K |
| 99443 | <1% | 175 | $7K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 125 | $7K |
| 81003 | <1% | 3,464 | $6K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 454 | $6K |
| 0071A | <1% | 138 | $6K | |
| 0072A | <1% | 130 | $5K | |
| 0064A | <1% | 231 | $5K | |
| 0124A | <1% | 128 | $4K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 40 | $4K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 37 | $4K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 139 | $4K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 50 | $2K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 26 | $2K |
| 81002 | <1% | 800 | $2K | |
| 0031A | <1% | 55 | $2K | |
| 0003A | <1% | 52 | $1K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 17 | $1K |
| 0052A | <1% | 54 | $992.25 | |
| 0013A | <1% | 26 | $915.86 | |
| 0134A | <1% | 21 | $867.09 | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 38 | $824.50 |
| 0082A | <1% | 16 | $660.64 | |
| 92341 | <1% | 36 | $580.00 | |
| 90480 | <1% | 13 | $498.49 | |
| 99441 | <1% | 31 | $364.13 | |
| 86580 | <1% | 62 | $338.01 | |
| 90473 | <1% | 33 | $337.26 | |
| 0051A | <1% | 13 | $243.00 | |
| 90474 | <1% | 28 | $226.50 | |
| 0053A | <1% | 14 | $222.75 | |
| 93000 | <1% | 13 | $157.14 | |
| 82043 | <1% | 14 | $38.40 | |
| 90686 | <1% | 74 | $37.00 | |
| 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 practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | 0% | 137 | $0.00 |
| 91301 | 0% | 120 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialPACHECO, CRISTINA (CEO)
| Provider | Location | Paid |
|---|---|---|
| Blackstone Valley Community Health Care | Pawtucket, RI | $14.24M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.