Clinic
South Cove Community Health Center, INC.
South Cove Community Health Center, INC. was paid $20.59M by Medicaid between Jan 2018 and Dec 2024, across 143 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 30% of everything it billed.
33Billing provider infoSOUTH COVE COMMUNITY HEALTH CENTER, INC.
BOSTON, MA 02111
BOSTON, MA 02111
33aNPI1700801263assigned 07/13/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$20.59M
24GClaims761,857
24DCodes billed143
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Massachusetts
Rank by total paid#9 of 56
Median peer was paid$1.51M
This provider vs. median14×
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 | 114,275 | $3.59M | |
| 2019 | 93,785 | $1.96M | |
| 2020 | 59,747 | $1.44M | |
| 2021 | 70,389 | $2.09M | |
| 2022 | 70,153 | $2.71M | |
| 2023 | 173,326 | $3.85M | |
| 2024incomplete | 180,182 | $4.96M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 30% | 126,029 | 102,501 | $6.20M |
| D9450 | 12% | 73,028 | 47,908 | $2.51M | |
| 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 | 6.6% | 7,285 | 6,504 | $1.36M |
| D1110 | Prophylaxis - adult | 4.9% | 30,575 | 22,165 | $1.00M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.6% | 105,381 | 87,194 | $741K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.5% | 69,770 | 61,266 | $714K |
| 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 | 3.4% | 20,166 | 16,634 | $693K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 2.8% | 20,654 | 20,575 | $582K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 2.6% | 33,159 | 25,319 | $532K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 2.5% | 7,053 | 6,095 | $523K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 1.9% | 8,706 | 8,693 | $395K |
| D0210 | Intraoral - complete series of radiographic images | 1.9% | 9,273 | 6,799 | $393K |
131 more codes
| D1120 | Dental cleaning, child | 1.7% | 7,051 | $355K |
| D0274 | Bitewings - four radiographic images | 1.5% | 13,198 | $313K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.4% | 8,166 | $284K |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 1.3% | 1,921 | $262K |
| D1206 | Topical application of fluoride varnish | 1.1% | 8,727 | $224K |
| 92341 | 1.1% | 6,398 | $223K | |
| D7140 | Extraction, erupted tooth or exposed root | 1.0% | 4,852 | $212K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 4,001 | $202K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 4,280 | $196K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 4,682 | $137K |
| D2140 | <1% | 3,007 | $119K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 4,259 | $118K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 1,747 | $112K |
| D1351 | Sealant - per tooth | <1% | 2,878 | $112K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 10,427 | $106K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 9,584 | $104K |
| D2331 | <1% | 1,965 | $91K | |
| 92015 | Determination of refractive state | <1% | 7,340 | $90K |
| 90674 | <1% | 6,517 | $87K | |
| D9110 | <1% | 2,837 | $77K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 800 | $71K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 930 | $71K |
| D2330 | <1% | 1,921 | $70K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 21,775 | $68K |
| 91322 | <1% | 858 | $66K | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 11,476 | $55K |
| 90661 | <1% | 2,216 | $48K | |
| 99397 | <1% | 1,613 | $46K | |
| D4341 | <1% | 822 | $44K | |
| 92250 | <1% | 1,787 | $44K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 2,284 | $42K |
| 90677 | <1% | 396 | $41K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 3,151 | $41K |
| 93000 | <1% | 3,381 | $37K | |
| 0064A | <1% | 2,238 | $37K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 822 | $36K |
| 77080 | <1% | 2,748 | $35K | |
| 90651 | <1% | 644 | $35K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 2,938 | $33K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 1,341 | $33K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 3,286 | $32K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | <1% | 13 | $28K |
| G0469 | Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new 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 | <1% | 129 | $27K |
| G0008 | Administration of influenza virus vaccine | <1% | 5,015 | $24K |
| 90480 | <1% | 916 | $24K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 627 | $23K |
| D0180 | <1% | 999 | $21K | |
| 90688 | <1% | 3,684 | $20K | |
| D0272 | Bitewings - two radiographic images | <1% | 797 | $20K |
| D2160 | <1% | 418 | $20K | |
| 99050 | <1% | 488 | $19K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 574 | $18K |
| 90756 | <1% | 1,431 | $18K | |
| 82270 | <1% | 11,726 | $17K | |
| 0134A | <1% | 1,324 | $17K | |
| D2332 | <1% | 283 | $15K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 7,500 | $15K |
| 90716 | <1% | 235 | $15K | |
| 0012A | <1% | 739 | $14K | |
| 90714 | <1% | 464 | $12K | |
| 99381 | <1% | 53 | $11K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 1,804 | $10K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 527 | $10K |
| 0011A | <1% | 706 | $10K | |
| 81002 | <1% | 3,497 | $9K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 63 | $7K |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 219 | $6K |
| 87400 | <1% | 599 | $6K | |
| 82948 | <1% | 2,740 | $6K | |
| D7111 | <1% | 77 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 434 | $5K |
| 99441 | <1% | 280 | $5K | |
| 77065 | Tomosynthesis, mammo | <1% | 48 | $5K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,702 | $5K |
| D3120 | <1% | 180 | $5K | |
| 90686 | <1% | 2,141 | $5K | |
| 90715 | <1% | 185 | $5K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 192 | $4K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 3,603 | $4K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 141 | $4K |
| 90694 | <1% | 215 | $4K | |
| 91301 | <1% | 760 | $4K | |
| 90653 | <1% | 341 | $3K | |
| 91306 | <1% | 1,681 | $3K | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | <1% | 22 | $3K |
| 85018 | <1% | 933 | $2K | |
| 90746 | <1% | 32 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 118 | $2K |
| 86580 | <1% | 235 | $2K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 115 | $2K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 13 | $2K |
| 81025 | <1% | 216 | $1K | |
| 90707 | <1% | 75 | $1K | |
| 0031A | <1% | 56 | $1K | |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 114 | $953.61 |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | <1% | 276 | $890.27 |
| G0009 | Administration of pneumococcal vaccine | <1% | 90 | $737.40 |
| 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 | <1% | 2,188 | $719.22 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 71 | $609.16 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 45 | $540.00 |
| 99442 | <1% | 16 | $496.18 | |
| 90474 | <1% | 43 | $370.86 | |
| D0270 | <1% | 43 | $370.00 | |
| 99459 | <1% | 13 | $200.98 | |
| 90732 | <1% | 15 | $196.41 | |
| 90620 | <1% | 340 | $134.94 | |
| 0071A | <1% | 14 | $91.74 | |
| 99051 | <1% | 57 | $69.68 | |
| 90619 | 0% | 292 | $0.00 | |
| 90656 | 0% | 2,067 | $0.00 | |
| 90660 | 0% | 15 | $0.00 | |
| 90744 | 0% | 36 | $0.00 | |
| 91307 | 0% | 17 | $0.00 | |
| 99000 | 0% | 154 | $0.00 | |
| 90680 | 0% | 116 | $0.00 | |
| 90696 | 0% | 14 | $0.00 | |
| 99386 | 0% | 13 | $0.00 | |
| 90723 | 0% | 111 | $0.00 | |
| 90697 | 0% | 12 | $0.00 | |
| 91303 | 0% | 12 | $0.00 | |
| 91313 | 0% | 930 | $0.00 | |
| 90621 | 0% | 102 | $0.00 | |
| 90734 | 0% | 304 | $0.00 | |
| 90670 | 0% | 150 | $0.00 | |
| 1159F | 0% | 54 | $0.00 | |
| 90648 | 0% | 145 | $0.00 | |
| 90700 | 0% | 46 | $0.00 | |
| 1160F | 0% | 54 | $0.00 | |
| 90710 | 0% | 13 | $0.00 | |
| 90685 | 0% | 69 | $0.00 | |
| 90633 | 0% | 98 | $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 officialWELCH, EUGENE (EXECUTIVE DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| South Cove Community Health Center | Boston, MA | $2.45M |
| South Cove Community Health Center, INC. | Quincy, MA | $314K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.