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EDWARD M. KENNEDY COMMUNITY HEALTH CENTER, INC

Clinic/Center, Federally Qualified Health Center (FQHC)·WORCESTER, MA·NPI: 1609842152Share

Compared to Clinic/Center, Federally Qualified Health Center (FQHC) Peers

Total spending distribution among 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $55.2M is at the below 25th percentile among 16 Clinic/Center, Federally Qualified Health Center (FQHC) providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$55.2M

$55,248,114

Total Claims

984K

Beneficiaries

789K

1.2 claims/patient

Avg Cost/Claim

$56

Monthly Spending Trend

Yearly Spending

2018
$7.3M
+5%
2019
$7.6M
+1%
2020
$7.7M
+28%
2021
$9.8M
+31%
2022
$12.8M
-40%
2023
$7.7M
-70%
2024
$2.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 56% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$30.9M

201K claims · 56.0%

Your Cost: $153.94/claim|Median: $121.16
1.3× median
D9450Normal range

$3.2M

136K claims · 5.8%

Your Cost: $23.29/claim|Median: $21.95
1.1× median
T1040Normal range

Medicaid certified CCBHC services

$2.1M

15K claims · 3.9%

Your Cost: $139.93/claim|Median: $130.29
1.1× median
G0470Top 10%

Chronic care management services, FQHC/RHC

$1.7M

10K claims · 3.1%

Your Cost: $165.45/claim|Median: $45.95
3.6× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$1.5M

10K claims · 2.8%

Your Cost: $148.39/claim|Median: $69.35
2.1× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$1.2M

8,260 claims · 2.2%

Your Cost: $148.60/claim|Median: $75.18
2.0× median
90834Normal range

Psychotherapy, 45 minutes

$1.2M

15K claims · 2.1%

Your Cost: $75.34/claim|Median: $63.65
1.2× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$1.1M

7,496 claims · 2.0%

Your Cost: $149.64/claim|Median: $74.82
2.0× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$1.0M

6,642 claims · 1.8%

Your Cost: $151.17/claim|Median: $80.15
1.9× median
99395Top 5%

Preventive medicine, established patient, age 18-39

$794K

5,213 claims · 1.4%

Your Cost: $152.33/claim|Median: $72.71
2.1× median
D0140Normal range

Limited oral evaluation, problem focused

$655K

31K claims · 1.2%

Your Cost: $21.00/claim|Median: $27.07
0.8× median
D1110Normal range

Prophylaxis, adult cleaning

$594K

28K claims · 1.1%

Your Cost: $21.07/claim|Median: $43.38
0.5× median
D7140Normal range

Extraction, erupted tooth or exposed root

$498K

12K claims · 0.9%

Your Cost: $42.45/claim|Median: $57.39
0.7× median
G0467Normal range

Federally qualified health center visit, mental health

$375K

12K claims · 0.7%

Your Cost: $31.79/claim|Median: $21.91
1.5× median
D0120Normal range

Periodic oral evaluation, established patient

$337K

27K claims · 0.6%

Your Cost: $12.30/claim|Median: $24.34
0.5× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$333K

13K claims · 0.6%

Your Cost: $25.51/claim|Median: $71.00
0.4× median
99381Top 5%

Preventive visit, new patient, infant (<1 yr)

$309K

1,645 claims · 0.6%

Your Cost: $187.73/claim|Median: $73.46
2.6× median
D1120Top 5%

Prophylaxis, adult

$305K

5,935 claims · 0.6%

Your Cost: $51.34/claim|Median: $33.86
1.5× median
D2391Normal range

Resin-based composite, one surface, posterior

$285K

14K claims · 0.5%

Your Cost: $20.56/claim|Median: $54.60
0.4× median
D0210Normal range

Intraoral, complete series of radiographic images

$252K

12K claims · 0.5%

Your Cost: $21.79/claim|Median: $46.33
0.5× median
90832Normal range

Psychotherapy, 30 minutes

$251K

6,444 claims · 0.5%

Your Cost: $39.02/claim|Median: $41.28
0.9× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$244K

3,591 claims · 0.4%

Your Cost: $67.91/claim|Median: $59.72
1.1× median
D0220Normal range

Intraoral periapical radiographic image, first film

$222K

26K claims · 0.4%

Your Cost: $8.54/claim|Median: $10.51
0.8× median
D2740Normal range

Crown, porcelain/ceramic substrate

$218K

1,158 claims · 0.4%

Your Cost: $188.35/claim|Median: $509.58
0.4× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$208K

11K claims · 0.4%

Your Cost: $19.22/claim|Median: $32.07
0.6× median
99050Top 5%

$207K

4,600 claims · 0.4%

Your Cost: $45.03/claim|Median: $11.81
3.8× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$196K

3,918 claims · 0.4%

Your Cost: $49.99/claim|Median: $47.08
1.1× median
D0274Normal range

Bitewings, four radiographic images

$188K

12K claims · 0.3%

Your Cost: $15.51/claim|Median: $22.54
0.7× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$186K

46K claims · 0.3%

Your Cost: $4.04/claim|Median: $9.80
0.4× median
97802Top 25%

Medical nutrition therapy, reassessment, individual, fifteen minutes

$168K

3,206 claims · 0.3%

Your Cost: $52.55/claim|Median: $12.70
4.1× median
96110Normal range

Developmental screening, per standardized instrument

$156K

16K claims · 0.3%

Your Cost: $9.64/claim|Median: $9.10
1.1× median
97803Normal range

Medical nutrition therapy, reassessment, group, thirty minutes

$155K

4,330 claims · 0.3%

Your Cost: $35.76/claim|Median: $24.33
1.5× median
D1208Top 5%

Topical application of fluoride, excluding varnish

$153K

5,290 claims · 0.3%

Your Cost: $28.91/claim|Median: $14.36
2.0× median
92340Top 25%

Fitting of spectacles, except for aphakia

$151K

5,558 claims · 0.3%

Your Cost: $27.26/claim|Median: $19.46
1.4× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$150K

4,684 claims · 0.3%

Your Cost: $31.93/claim|Median: $30.04
1.1× median
D1351Top 25%

Sealant, per tooth

$137K

3,382 claims · 0.2%

Your Cost: $40.55/claim|Median: $26.10
1.6× median
D0180Normal range

$130K

9,848 claims · 0.2%

Your Cost: $13.20/claim|Median: $35.21
0.4× median
90746Top 25%

Hepatitis B vaccine, adult

$118K

1,811 claims · 0.2%

Your Cost: $65.40/claim|Median: $48.85
1.3× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$115K

19K claims · 0.2%

Your Cost: $6.16/claim|Median: $7.18
0.9× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$103K

3,448 claims · 0.2%

Your Cost: $29.86/claim|Median: $73.58
0.4× median
D3330Normal range

Endodontic therapy, molar (excluding final restoration)

$101K

407 claims · 0.2%

Your Cost: $249.20/claim|Median: $463.40
0.5× median
D2335Normal range

$92K

1,922 claims · 0.2%

Your Cost: $47.73/claim|Median: $105.06
0.5× median
G2023Top 25%

Specimen collection for COVID-19 testing

$90K

3,838 claims · 0.2%

Your Cost: $23.43/claim|Median: $17.15
1.4× median
D2393Normal range

Resin-based composite, three surfaces, posterior

$89K

3,070 claims · 0.2%

Your Cost: $29.08/claim|Median: $84.26
0.3× median
D2751Normal range

Crown, porcelain fused to predominantly base metal

$88K

575 claims · 0.2%

Your Cost: $152.90/claim|Median: $476.00
0.3× median
92015Normal range

Determination of refractive state

$87K

7,796 claims · 0.2%

Your Cost: $11.16/claim|Median: $10.36
1.1× median
90715Normal range

Tdap vaccine

$84K

4,709 claims · 0.2%

Your Cost: $17.79/claim|Median: $10.32
1.7× median
D5212Normal range

$83K

535 claims · 0.2%

Your Cost: $155.15/claim|Median: $402.44
0.4× median
D9110Normal range

$81K

3,598 claims · 0.1%

Your Cost: $22.64/claim|Median: $38.08
0.6× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$79K

2,983 claims · 0.1%

Your Cost: $26.43/claim|Median: $66.63
0.4× median

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