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SOUTH COVE COMMUNITY HEALTH CENTER, INC.

Clinic/Center, Federally Qualified Health Center (FQHC)·BOSTON, MA·NPI: 1700801263Share

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 $20.6M 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

$20.6M

$20,588,901

Total Claims

762K

Beneficiaries

625K

1.2 claims/patient

Avg Cost/Claim

$27

Monthly Spending Trend

Yearly Spending

2018
$3.6M
-45%
2019
$2.0M
-26%
2020
$1.4M
+45%
2021
$2.1M
+30%
2022
$2.7M
+42%
2023
$3.9M
+29%
2024
$5.0M

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 30% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$6.2M

126K claims · 30.1%

Your Cost: $49.19/claim|Median: $121.16
0.4× median
D9450Top 25%

$2.5M

73K claims · 12.2%

Your Cost: $34.38/claim|Median: $21.95
1.6× median
G0470Top 10%

Chronic care management services, FQHC/RHC

$1.4M

7,285 claims · 6.6%

Your Cost: $186.99/claim|Median: $45.95
4.1× median
D1110Normal range

Prophylaxis, adult cleaning

$1.0M

31K claims · 4.9%

Your Cost: $32.72/claim|Median: $43.38
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$741K

105K claims · 3.6%

Your Cost: $7.03/claim|Median: $25.06
0.3× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$714K

70K claims · 3.5%

Your Cost: $10.24/claim|Median: $37.81
0.3× median
G0467Top 25%

Federally qualified health center visit, mental health

$693K

20K claims · 3.4%

Your Cost: $34.34/claim|Median: $21.91
1.6× median
92340Top 25%

Fitting of spectacles, except for aphakia

$582K

21K claims · 2.8%

Your Cost: $28.19/claim|Median: $19.46
1.4× median
D0120Normal range

Periodic oral evaluation, established patient

$532K

33K claims · 2.6%

Your Cost: $16.06/claim|Median: $24.34
0.7× median
77067Top 25%

Screening mammography, bilateral, including CAD

$523K

7,053 claims · 2.5%

Your Cost: $74.21/claim|Median: $39.33
1.9× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$395K

8,706 claims · 1.9%

Your Cost: $45.33/claim|Median: $47.08
1.0× median
D0210Normal range

Intraoral, complete series of radiographic images

$393K

9,273 claims · 1.9%

Your Cost: $42.39/claim|Median: $46.33
0.9× median
D1120Top 10%

Prophylaxis, adult

$355K

7,051 claims · 1.7%

Your Cost: $50.34/claim|Median: $33.86
1.5× median
D0274Normal range

Bitewings, four radiographic images

$313K

13K claims · 1.5%

Your Cost: $23.69/claim|Median: $22.54
1.1× median
D2391Normal range

Resin-based composite, one surface, posterior

$284K

8,166 claims · 1.4%

Your Cost: $34.82/claim|Median: $54.60
0.6× median
T1040Normal range

Medicaid certified CCBHC services

$262K

1,921 claims · 1.3%

Your Cost: $136.48/claim|Median: $130.29
1.0× median
D1206Top 25%

Topical application of fluoride varnish

$224K

8,727 claims · 1.1%

Your Cost: $25.72/claim|Median: $18.12
1.4× median
92341Top 10%

$223K

6,398 claims · 1.1%

Your Cost: $34.79/claim|Median: $22.77
1.5× median
D7140Normal range

Extraction, erupted tooth or exposed root

$212K

4,852 claims · 1.0%

Your Cost: $43.68/claim|Median: $57.39
0.8× median
D2150Normal range

Amalgam, two surfaces, primary or permanent

$202K

4,001 claims · 1.0%

Your Cost: $50.48/claim|Median: $66.00
0.8× median
D2392Normal range

Resin-based composite, two surfaces, posterior

$196K

4,280 claims · 1.0%

Your Cost: $45.80/claim|Median: $71.00
0.6× median
D0150Normal range

Comprehensive oral evaluation, new or established patient

$137K

4,682 claims · 0.7%

Your Cost: $29.33/claim|Median: $32.07
0.9× median
D2140Normal range

Amalgam, one surface, primary or permanent

$119K

3,007 claims · 0.6%

Your Cost: $39.48/claim|Median: $52.77
0.7× median
D0140Normal range

Limited oral evaluation, problem focused

$118K

4,259 claims · 0.6%

Your Cost: $27.73/claim|Median: $27.07
1.0× median
90834Normal range

Psychotherapy, 45 minutes

$112K

1,747 claims · 0.5%

Your Cost: $63.94/claim|Median: $63.65
1.0× median
D1351Top 25%

Sealant, per tooth

$112K

2,878 claims · 0.5%

Your Cost: $38.75/claim|Median: $26.10
1.5× median
96110Normal range

Developmental screening, per standardized instrument

$106K

10K claims · 0.5%

Your Cost: $10.18/claim|Median: $9.10
1.1× median
D0220Normal range

Intraoral periapical radiographic image, first film

$104K

9,584 claims · 0.5%

Your Cost: $10.84/claim|Median: $10.51
1.0× median
D2331Normal range

Resin-based composite filling, two surfaces, anterior

$91K

1,965 claims · 0.4%

Your Cost: $46.11/claim|Median: $73.58
0.6× median
92015Normal range

Determination of refractive state

$90K

7,340 claims · 0.4%

Your Cost: $12.29/claim|Median: $10.36
1.2× median
90674Normal range

$87K

6,517 claims · 0.4%

Your Cost: $13.33/claim|Median: $15.16
0.9× median
D9110Normal range

$77K

2,837 claims · 0.4%

Your Cost: $27.07/claim|Median: $38.08
0.7× median
99391Top 25%

Preventive medicine, established patient, infant (under 1)

$71K

800 claims · 0.3%

Your Cost: $88.67/claim|Median: $69.35
1.3× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$71K

930 claims · 0.3%

Your Cost: $75.95/claim|Median: $59.72
1.3× median
D2330Normal range

Resin-based composite filling, one surface, anterior

$70K

1,921 claims · 0.3%

Your Cost: $36.67/claim|Median: $66.63
0.6× median
90471Normal range

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

$68K

22K claims · 0.3%

Your Cost: $3.14/claim|Median: $9.80
0.3× median
91322Normal range

$66K

858 claims · 0.3%

Your Cost: $76.82/claim|Median: $76.28
1.0× median
G0439Normal range

Annual wellness visit, subsequent visit

$55K

11K claims · 0.3%

Your Cost: $4.81/claim|Median: $5.42
0.9× median
90661Normal range

$48K

2,216 claims · 0.2%

Your Cost: $21.81/claim|Median: $14.37
1.5× median
99397Normal range

$46K

1,613 claims · 0.2%

Your Cost: $28.32/claim|Median: $22.92
1.2× median
D4341Normal range

Periodontal scaling, per quadrant

$44K

822 claims · 0.2%

Your Cost: $53.87/claim|Median: $70.00
0.8× median
92250Normal range

Fundus photography with interpretation and report

$44K

1,787 claims · 0.2%

Your Cost: $24.78/claim|Median: $27.95
0.9× median
99395Normal range

Preventive medicine, established patient, age 18-39

$42K

2,284 claims · 0.2%

Your Cost: $18.56/claim|Median: $72.71
0.3× median
90677Top 25%

$41K

396 claims · 0.2%

Your Cost: $104.34/claim|Median: $12.96
8.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$41K

3,151 claims · 0.2%

Your Cost: $13.07/claim|Median: $74.82
0.2× median
93000Normal range

Electrocardiogram, complete, with interpretation and report

$37K

3,381 claims · 0.2%

Your Cost: $11.06/claim|Median: $9.70
1.1× median
0064ANormal range

$37K

2,238 claims · 0.2%

Your Cost: $16.61/claim|Median: $34.17
0.5× median
90832Normal range

Psychotherapy, 30 minutes

$36K

822 claims · 0.2%

Your Cost: $44.01/claim|Median: $41.28
1.1× median
77080Normal range

Dual-energy x-ray absorptiometry (DEXA) bone density scan

$35K

2,748 claims · 0.2%

Your Cost: $12.81/claim|Median: $18.93
0.7× median
90651Top 10%

HPV vaccine, 9-valent

$35K

644 claims · 0.2%

Your Cost: $53.84/claim|Median: $8.93
6.0× median

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