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 1609813500)

Field	Value
Entity Type	Organization
Organization	Southern Illinois Healthcare Foundation Inc
Address	6000 Bond Ave
City	Centreville
State	IL
ZIP	62207
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$17.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

88 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	128,590	$130	$16.7M
D0999	N/A	8,130	$120	$992.1K
T1040	Medicaid certified community behavioral health clinic services, per diem	880	$80	$65.8K
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.	500	$1	$500
90716	The provider administers a live vaccine subcutaneously to protect against varicella infection.	480	$1	$480
0500F	No Summary found for this code	690	$0	$0
0502F	No Summary found for this code	5,400	$0	$0
0503F	No Summary found for this code	50	$0	$0
1036F	N/A	7,370	$0	$0
1125F	The provider measures the severity of pain in a patient with cancer who receives chemotherapy or radiotherapy during the measurement period. Report this code if the patient experiences pain.	50	$0	$0

Showing 1–10 of 88

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 5 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

88 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	40	850	7,490	$120	$3.9M
D0999	N/A	53	220	1,090	$110	$610.1K
T1040	Medicaid certified community behavioral health clinic services, per diem	96	190	880	$70	$128.2K
D1120	Prophylaxis–child	228	2,140	960	$40	$89.1K
D1351	Sealant - per tooth	1,095	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…	57	760	140	$110	$67.3K
D0120	Periodic oral evaluation - established patient	340	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…	73	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…	35	14,680	300	$50	$48.7K
0502F	No Summary found for this code	80	1,170	550	$30	$48.2K

Showing 1–10 of 88

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	$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
Haley Mayo	IL	Physician Assistant	$47.6K	$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