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    v1.0.28
    OpenPayerNPI Medicare & MedicaidCarle Foundation Hospital
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    Carle Foundation Hospital — Billing Profile & Reimbursement Data

    NPI 1083736177 · Urbana, IL · General Acute Care Hospital

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    Carle Foundation Hospital is a general acute care hospital provider located in Urbana, Illinois. This profile covers 0 Medicare and 321 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCarle Foundation Hospital
    Address611 W Park St
    CityUrbana
    StateIL
    ZIP61801
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedApril 6, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$8.3M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    321 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…38,590$80$3.2M
    97162The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…5,120$110$568.8K
    92507The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…12,400$30$396.9K
    U00042019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…4,500$70$323.9K
    87502The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…4,770$40$210K
    J1050Injection, medroxyprogesterone acetate, 1 mg4,120$50$206K
    90732The provider intramuscularly or subcutaneously injects pneumococcal polysaccharide vaccine in an individual two years or older. This vaccine provides protection against meningitis and pneumonia that…1,470$100$139.5K
    L4360Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a…920$140$128.8K
    90670This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…9,770$10$127K
    0502FNo Summary found for this code3,020$40$126.8K

    Showing 1–10 of 321

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    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Illinois median

    321 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    U00042019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…1450710$70$1.2M
    G0463Hospital outpatient clinic visit for assessment and management of a patient43050$50$422.6K
    J7298Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg310120$830$372.2K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.1432801,120$30$218.9K
    87633The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…152170150$200$190.9K
    87801The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.24110150$40$184.1K
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…131,220540$60$179.4K
    87591The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.31360600$30$165.1K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.31360630$30$165K
    A6449Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard310290$30$155.1K

    Showing 1–10 of 321

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    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Carle Foundation Hospital, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Carle Foundation HospitalILHome Health Agency$0$6.4M
    The Carle Foundation HospitalILDurable Medical Equipment & Medical Supplies$0$4.8M

    Nearby Providers

    Other providers in the same ZIP code as Carle Foundation Hospital, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Osf Healthcare SystemILLand Ambulance$0$5.2M
    Aashish GandhiILOphthalmology Physician$1.7M$54.1K
    Yujie ZhaoILHematology & Oncology Physician$1.1M$13.7K
    Sami SibaiILDiagnostic Radiology Physician$184.8K$846.8K
    Jeremy YouseILMOHS-Micrographic Surgery Physician$993.9K$15.1K
    Abdel-moneim AttiaILNephrology Physician$297.4K$582.1K
    Leanne LabriolaILOphthalmology Physician$726.1K$108.2K
    Vikas PatelILDermatology Physician$705.9K$0
    Yongsoo KwonILSurgery Physician$591.8K$28.1K
    Recovery Concepts Urbana, LLCILMethadone Clinic$114.7K$414.5K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Illinois Providers
    3 of 5 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Illinois Distribution
    Carle Foundation Hospital — 12 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Illinois