Clinic
Community Health Programs
Community Health Programs was paid $653K by Medicaid between Jan 2018 and Nov 2024, across 25 billing codes. Its largest line is D9450, — 36% of everything it billed.
33Billing provider infoCOMMUNITY HEALTH PROGRAMS
NORTH ADAMS, MA 01247
NORTH ADAMS, MA 01247
33aNPI1194195206assigned 10/01/2015
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$653K
24GClaims21,010
24DCodes billed25
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Massachusetts
Rank by total paid#34 of 56
Median peer was paid$1.51M
This provider vs. median0.4×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official JOHNSON, KAREN controls 15+ related entities in our dataset. Read more
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 | 2,087 | $44K | |
| 2019 | 1,490 | $26K | |
| 2020 | 1,486 | $25K | |
| 2021 | 4,946 | $97K | |
| 2022 | 2,935 | $109K | |
| 2023 | 2,080 | $57K | |
| 2024incomplete | 5,986 | $295K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9450 | 36% | 3,896 | 3,055 | $236K | |
| G0467 | Community health center visit, returning patientFederally 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 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 fqhc visit | 30% | 6,391 | 5,592 | $196K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 8.8% | 461 | 407 | $58K |
| D1110 | Prophylaxis - adult | 5.9% | 890 | 714 | $38K |
| D0210 | Intraoral - complete series of radiographic images | 2.8% | 281 | 256 | $18K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.6% | 427 | 382 | $17K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.5% | 335 | 318 | $17K |
| D0140 | Limited oral evaluation - problem focused | 2.5% | 468 | 400 | $16K |
| D1206 | Topical application of fluoride varnish | 1.9% | 505 | 478 | $13K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 1.8% | 574 | 501 | $12K |
| D0274 | Bitewings - four radiographic images | 1.4% | 279 | 244 | $9K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1.3% | 108 | 85 | $9K |
13 more codes
| D0220 | Intraoral - periapical first radiographic image | 1.0% | 566 | $7K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 62 | $4K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 113 | $2K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 34 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 92 | $886.00 |
| D9110 | <1% | 17 | $681.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 4,058 | $0.00 |
| 99213 | Doctor's office visit, returning patient (routine) | 0% | 1,250 | $0.00 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 37 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 22 | $0.00 |
| G0468 | Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv | 0% | 51 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 61 | $0.00 |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 32 | $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 officialJOHNSON, KAREN (CHIEF HUMAN RESOURCES AND COMPLIAN)
| Provider | Location | Paid |
|---|---|---|
| Lawndale Christian Health Center | Chicago, IL | $103.50M |
| Community Health Programs | Pittsfield, MA | $4.24M |
| Huntsville Isd | Huntsville, TX | $3.39M |
| Lawndale Christian Health Center | Chicago, IL | $952K |
| DR. KG Johnson and Associates, LLC | Washington, DC | $878K |
| Garden City Usd 457 | Garden City, KS | $812K |
| Henderson Family Eye Care, PLLC | Henderson, TN | $524K |
| Lawndale Christian Health Center | Chicago, IL | $307K |
| Lawndale Christian Health Center | Chicago, IL | $297K |
| Lawndale Christian Health Center | Chicago, IL | $216K |
| Community Health Programs | Lee, MA | $197K |
| Choices Recovery Services INC | Sioux Falls, SD | $118K |
| Community Health Programs | Great Barrington, MA | $52K |
| Ohio Eyecare Specialists, INC | Dayton, OH | $4K |
| Northern Orthopedics LTD | Brainerd, MN | $3K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.