Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Illinois for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Illinois only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Illinois (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Southern Illinois Medical Services, Nfp (NPI 1215204938)

Field	Value
Entity Type	Organization
Organization	Southern Illinois Medical Services, Nfp
Address	502 W Saint Louis St Ste 4
City	West Frankfort
State	IL
ZIP	62896
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	November 23, 2011

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	64,140	$70	$4.6M
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	2,400	$0	$0
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	460	$0	$0
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,100	$0	$0
87807	The lab analyst performs the technical lab test to analyze for the presence of respiratory syncytial virus (RSV) in a specimen by immunoassay using direct optical, meaning visual, observation.	50	$0	$0
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	2,150	$0	$0
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	50	$0	$0
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	610	$0	$0
90656	This code represents a preservative–free trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	40	$0	$0
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	600	$0	$0

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Southern Illinois Medical Services, Nfp — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	104	850	7,490	$120	$3.9M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	58	14,680	300	$50	$48.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	101	14,190	280	$20	$38.9K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	605	1,540	410	$20	$30.2K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	1,415	1,590	360	$10	$23K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	1,642	2,800	60	$80	$17.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	589	930	60	$40	$12.2K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	718	3,270	80	$40	$11.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	79	1,550	120	$20	$8.4K
90732	The provider intramuscularly or subcutaneously injects pneumococcal polysaccharide vaccine in an individual two years or older. This vaccine provides protection against meningitis and pneumonia that…	28	50	50	$50	$8.3K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southern Illinois Medical Services, Nfp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Illinois Medical Services, Nfp	IL	Rural Health Clinic/Center	$0	$15.2M
Southern Illinois Medical Services, Nfp	IL	Rural Health Clinic/Center	$0	$12.5M
Southern Illinois Medical Services, Nfp	IL	Rural Health Clinic/Center	$0	$9.2M
Nader Dababneh	IL	Gastroenterology Physician	$111.5K	$813.7K
Fadi Aldaas	IL	Critical Care Medicine (Internal Medicine) Physician	$525.7K	$302K
Gerson Criste	IL	Pain Medicine (Psychiatry & Neurology) Physician	$181.3K	$514.7K
Vadzim Chyzhyk	IL	Cardiovascular Disease Physician	$276.8K	$414.9K
Hal Lewis	IL	Dermatology Physician	$341.1K	$202.4K
Cesar Coello	IL	Cardiovascular Disease Physician	$291.2K	$191.4K
Abbas Omais	MD	Pulmonary Disease Physician	$454.3K	$9K

Nearby Providers

Other providers in the same ZIP code as Southern Illinois Medical Services, Nfp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centerstone Of Illinois, Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.3M
Jared Johnston	IL	Physical Therapist	$154.1K	$0
David Mason	IL	Physician Assistant	$78.6K	$0

Southern Illinois Medical Services, Nfp — Billing Profile & Reimbursement Data

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Southern Illinois Medical Services, Nfp — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References