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 Health Care Foundation, Inc. (NPI 1780609578)

Field	Value
Entity Type	Organization
Organization	Southern Illinois Health Care Foundation, Inc.
Address	180 S 3rd St Ste 103&104
City	Belleville
State	IL
ZIP	62220
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 13, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

54 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	40,130	$130	$5.2M
T1040	Medicaid certified community behavioral health clinic services, per diem	570	$70	$39.4K
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.	740	$1	$740
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…	400	$1	$400
S5190	Wellness assessment, performed by non-physician	290	$1	$290
90707	This code represents an MMR vaccine product administered beneath the skin to protect against measles, mumps, and rubella (German measles).	30	$10	$150
1036F	N/A	1,900	$0	$0
1160F	No Summary found for this code	290	$0	$0
3008F	No Summary found for this code	2,840	$0	$0
3074F	No Summary found for this code	1,950	$0	$0

Showing 1–10 of 54

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 Health Care Foundation, Inc. — 0 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

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	172	850	7,490	$120	$3.9M
T1040	Medicaid certified community behavioral health clinic services, per diem	112	190	880	$70	$128.2K
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…	299	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…	2,584	14,680	300	$50	$48.7K
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…	928	1,380	370	$40	$46.2K
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…	299	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.	334	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.	213	1,590	110	$40	$21.4K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	192	820	340	$1	$17.9K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	235	570	80	$40	$15.2K

Showing 1–10 of 54

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Direct Medical, Incorporated	IL	Durable Medical Equipment & Medical Supplies	$0	$4.1M
David Oneill	IL	Family Medicine Physician	$188.2K	$27.9K
Douglas Despain	IL	Family Medicine Physician	$63.8K	$0
Andrew Griffin	IL	Certified Registered Nurse Anesthetist	$48.9K	$12.7K
Alexander Pederson	IL	Anatomic Pathology & Clinical Pathology Physician	$61.2K	$0
Melinda Walker	IL	Family Medicine Physician	$41K	$0
Jamee Ahlers	IL	Speech-Language Pathologist	$40.2K	$0

Southern Illinois Health Care Foundation, Inc. — Billing Profile & Reimbursement Data

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Southern Illinois Health Care 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