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 Healthcare Foundation, Inc (NPI 1275561797)

Field	Value
Entity Type	Organization
Organization	Southern Illinois Healthcare Foundation, Inc
Address	7210 W Main St
City	Belleville
State	IL
ZIP	62223
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 30, 2006

Payer Source	Total Paid
Medicaid	$10.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

67 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	83,590	$120	$9.9M
D0999	N/A	2,410	$110	$267.7K
T1040	Medicaid certified community behavioral health clinic services, per diem	530	$70	$36.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	2,300	$1	$2.3K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	940	$1	$940
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…	890	$1	$890
0500F	No Summary found for this code	870	$0	$0
0502F	No Summary found for this code	7,600	$0	$0
0503F	No Summary found for this code	710	$0	$0
1036F	N/A	5,360	$0	$0

Showing 1–10 of 67

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 Healthcare Foundation, Inc — 1 of 6 codes 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

67 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	70	850	7,490	$120	$3.9M
D0999	N/A	86	220	1,090	$110	$610.1K
T1040	Medicaid certified community behavioral health clinic services, per diem	114	190	880	$70	$128.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	671	1,180	370	$90	$109.7K
D1120	Prophylaxis–child	880	2,140	960	$40	$89.1K
D1351	Sealant - per tooth	1,005	1,270	530	$60	$87.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	216	760	140	$110	$67.3K
D0120	Periodic oral evaluation - established patient	1,096	2,170	1,010	$30	$64.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	74	960	330	$30	$51K
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…	419	14,680	300	$50	$48.7K

Showing 1–10 of 67

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southern Illinois Healthcare Foundation, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Illinois Health Care Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$21.1M
Southern Illinois Healthcare Foundation, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$20.4M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$20.4M
Southern Illinois Healthcare Foundation Inc	IL	Federally Qualified Health Center (FQHC)	$0	$17.8M
Southern Illinois Healthcare Foundation, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$12.1M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$9.8M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$7.9M
Southern Illinois Healthcare Foundation Inc	IL	Federally Qualified Health Center (FQHC)	$0	$7.9M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$6.3M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$6.3M

Nearby Providers

Other providers in the same ZIP code as Southern Illinois Healthcare Foundation, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chestnut Health Systems, Inc.	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.2M
Iv Care, LLC	IL	Home Infusion Therapy Pharmacy	$0	$10.4M
David Norman	IL	Pediatrics Physician	$0	$5.4M
Vasantha Pai	IL	Gastroenterology Physician	$576.5K	$777.8K
Medicine Express, LLC	IL	Long Term Care Pharmacy	$260.8K	$0
Eric Whittenburg	IL	Foot & Ankle Surgery Podiatrist	$153.2K	$0
Casandra Roy	IL	Family Nurse Practitioner	$79.5K	$47.1K
Rebecca Blandina	IL	Occupational Therapist	$103K	$3.2K
Oliver Wolfe	IL	Anesthesiology Physician	$100.3K	$0
Melissa Helfrich	IL	Optometrist	$69.1K	$0

Southern Illinois Healthcare Foundation, Inc — Billing Profile & Reimbursement Data

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Southern Illinois Healthcare Foundation, Inc — 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