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 1376588871)

Field	Value
Entity Type	Organization
Organization	Southern Illinois Healthcare Foundation, Inc.
Address	2900 Frank Scott Pkwy W
City	Belleville
State	IL
ZIP	62223
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 18, 2006

Payer Source	Total Paid
Medicaid	$6.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

56 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	45,940	$140	$6.2M
T1040	Medicaid certified community behavioral health clinic services, per diem	1,000	$80	$75.3K
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,…	1,950	$1	$2K
1036F	N/A	3,160	$0	$0
1160F	No Summary found for this code	4,430	$0	$0
3008F	No Summary found for this code	8,050	$0	$0
3074F	No Summary found for this code	4,500	$0	$0
3078F	No Summary found for this code	4,280	$0	$0
3079F	No Summary found for this code	80	$0	$0
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	2,320	$0	$0

Showing 1–10 of 56

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. — 0 of 3 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

56 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	150	850	7,490	$120	$3.9M
T1040	Medicaid certified community behavioral health clinic services, per diem	85	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…	698	1,180	370	$90	$109.7K
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…	103	960	330	$30	$51K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	29	1,380	370	$40	$46.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	30	1,270	370	$40	$40.8K
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…	346	14,190	280	$20	$38.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	32	1,670	160	$40	$26.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	51	1,590	110	$40	$21.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	200	750	60	$50	$19.9K

Showing 1–10 of 56

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	$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

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