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.

Shawnee Health Service And Development Corp (NPI 1811928732)

Field	Value
Entity Type	Organization
Organization	Shawnee Health Service And Development Corp
Address	1006 S Division St
City	Carterville
State	IL
ZIP	62918
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 6, 2006

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	54,090	$110	$5.8M
T1040	Medicaid certified community behavioral health clinic services, per diem	3,250	$80	$243.4K
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an…	730	$10	$9.5K
0012A	N/A	60	$40	$2.7K
0011A	N/A	60	$40	$2.6K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,240	$1	$1.2K
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…	430	$1	$430
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	90	$10	$430
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	270	$1	$270
90715	The provider uses this combination vaccine as a booster to help protect patients who are 7 years old or older from lockjaw, diphtheria, and whooping cough.	200	$1	$200

Showing 1–10 of 47

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

Shawnee Health Service And Development Corp — 1 of 10 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

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	128	850	7,490	$120	$3.9M
T1040	Medicaid certified community behavioral health clinic services, per diem	32	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…	536	1,180	370	$90	$109.7K
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…	241	360	300	$50	$67.4K
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…	67	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…	272	14,680	300	$50	$48.7K
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…	148	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.	831	1,670	160	$40	$26.4K
90834	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…	46	720	250	$30	$25.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	552	1,590	110	$40	$21.4K

Showing 1–10 of 47

Related Providers

Other providers that share a Tax Identification Number (TIN) with Shawnee Health Service And Development Corp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shawnee Health Service And Development Corp	IL	Federally Qualified Health Center (FQHC)	$0	$13.2M
Shawnee Health Service And Development Corp	IL	Federally Qualified Health Center (FQHC)	$0	$11.1M
Shawnee Health Service And Development Corp	IL	Federally Qualified Health Center (FQHC)	$0	$9.7M
Shawnee Health Service And Development Corp	IL	Federally Qualified Health Center (FQHC)	$0	$6.8M
Shawnee Health Service And Development Corp	IL	Federally Qualified Health Center (FQHC)	$0	$6.7M
Shawnee Health Service & Development Corp	IL	Federally Qualified Health Center (FQHC)	$0	$4M
Kalpesh Patel	IL	Internal Medicine Physician	$229.4K	$37.8K
Kimberly Middleton	TX	Family Medicine Physician	$111K	$0

Nearby Providers

Other providers in the same ZIP code as Shawnee Health Service And Development Corp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centerstone Of Illinois, Inc	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.1M
Michael Little	IL	Radiation Oncology Physician	$216.6K	$47.1K
Babu Prasad	IL	Pain Medicine (Anesthesiology) Physician	$110.3K	$1.4K
Christy Ogden	IL	Speech-Language Pathologist	$83.2K	$0
Cassandra Vestal	IL	Nurse Practitioner	$37.1K	$0
Alex Witcher	IL	Certified Registered Nurse Anesthetist	$2.6K	$0

Shawnee Health Service And Development Corp — Billing Profile & Reimbursement Data

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Shawnee Health Service And Development Corp — 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