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 Hospital Services (NPI 1528158573)

Southern Illinois Hospital Services is a general acute care hospital provider located in Herrin, Illinois. This profile covers 0 Medicare and 153 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Southern Illinois Hospital Services
Address	201 S 14th St
City	Herrin
State	IL
ZIP	62948
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

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

153 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic 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…	42,700	$90	$4M
97162	The 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…	2,890	$120	$332.2K
G0283	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care	6,960	$20	$125.3K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	8,670	$10	$86.7K
97161	The 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…	760	$110	$84.8K
87633	The 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…	540	$150	$80.1K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	6,690	$10	$46.8K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	780	$60	$44.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	1,800	$20	$43.1K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	390	$110	$42.6K

Showing 1–10 of 153

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 Hospital Services — 5 of 25 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

153 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	42	70	570	$50	$565.6K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	171	350	400	$70	$514.7K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	8	10	2,430	$70	$286.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	119	280	1,120	$30	$218.9K
87902	The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus.	6	10	80	$160	$192K
87633	The 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…	50	170	150	$200	$190.9K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	103	250	450	$40	$185.7K
97110	Therapeutic 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…	10	1,220	540	$60	$179.4K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	145	160	300	$20	$145.2K
92507	The 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…	409	1,210	1,070	$30	$102.1K

Showing 1–10 of 153

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cesar Coello	IL	Cardiovascular Disease Physician	$291.2K	$191.4K
Raed Al-dallow	IL	Interventional Cardiology Physician	$231.5K	$156.9K
Son Le	IL	Interventional Cardiology Physician	$133.7K	$138.7K
Magdalena Zeglin	VT	Interventional Cardiology Physician	$7.5K	$19K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Illinois Medical Services, Nfp	IL	Rural Health Clinic/Center	$0	$9.2M
Southern Orthopedic Associates Sc	IL	Orthopaedic Surgery Physician	$0	$3.2M
Ted Van Acker	IL	Dermatology Physician	$1.4M	$320.7K
Sushilkumar Tibrewala	IL	Gastroenterology Physician	$131.6K	$807K
Mustafa Hindi	IL	Emergency Medicine Physician	$107.8K	$744.8K
Mack Mccain	IL	Gastroenterology Physician	$92.3K	$702.2K
Derek Kenneaster	IL	Dermatology Physician	$229.5K	$343.5K
Terrence Glennon	IL	Physical Medicine & Rehabilitation Physician	$149.4K	$311.3K
Southern Illinois Orthopedic Center,llc	IL	Ambulatory Surgical Clinic/Center	$446.3K	$0
Gerri Dyer	IL	Nurse Practitioner	$175.1K	$109.5K

Southern Illinois Hospital Services — Billing Profile & Reimbursement Data

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Southern Illinois Hospital Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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