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 1326392747)

Field	Value
Entity Type	Organization
Organization	Southern Illinois Healthcare Foundation, Inc
Address	2166 Madison Avenue
City	Granite City
State	IL
ZIP	62040
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 7, 2012

Payer Source	Total Paid
Medicaid	$20.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

104 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	152,210	$130	$19M
D0999	N/A	8,200	$120	$991.6K
T1040	Medicaid certified community behavioral health clinic services, per diem	4,380	$70	$324.4K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	2,970	$10	$17.8K
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…	6,250	$1	$6.3K
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.	1,700	$1	$1.7K
90716	The provider administers a live vaccine subcutaneously to protect against varicella infection.	670	$1	$670
90620	This code represents a vaccine product administered into the muscle to protect against meningococcal disease caused by serogroup B. This vaccine uses recombinant proteins and outer membrane vesicles…	300	$1	$300
0500F	No Summary found for this code	960	$0	$0
0502F	No Summary found for this code	7,870	$0	$0

Showing 1–10 of 104

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 — 4 of 8 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

104 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	31	850	7,490	$120	$3.9M
D0999	N/A	51	220	1,090	$110	$610.1K
T1040	Medicaid certified community behavioral health clinic services, per diem	18	190	880	$70	$128.2K
D1120	Prophylaxis–child	302	2,140	960	$40	$89.1K
D1351	Sealant - per tooth	1,119	1,270	530	$60	$87.1K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	220	360	300	$50	$67.4K
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…	692	760	140	$110	$67.3K
D0120	Periodic oral evaluation - established patient	419	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…	12	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…	110	14,680	300	$50	$48.7K

Showing 1–10 of 104

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	$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	$10.2M
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	$14.6M
Chestnut Health Systems, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$8.1M
City Of Granite City	IL	Land Ambulance	$280K	$3.8M
Arif Habib	IL	Psychiatry Physician	$91.4K	$1.9M
Rajinder Mahay	IL	Internal Medicine Physician	$154.8K	$116.6K
Kathryn Sarabia	IL	Certified Registered Nurse Anesthetist	$50K	$76.5K
Timothy O'connor	IL	Certified Registered Nurse Anesthetist	$21.4K	$0
David Bogolub	IL	Emergency Medicine Physician	$13.8K	$5.4K
Kristopher Klint	IL	Certified Registered Nurse Anesthetist	$18.5K	$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