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    OpenPayerNPI Medicare & MedicaidCentral Counties Health Centers, Inc.
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    Central Counties Health Centers, Inc. — Billing Profile & Reimbursement Data

    NPI 1861480709 · Springfield, IL · Federally Qualified Health Center (FQHC)

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    Central Counties Health Centers, Inc. is a federally qualified health center (fqhc) provider located in Springfield, Illinois. This profile covers 0 Medicare and 115 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 9

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCentral Counties Health Centers, Inc.
    Address2239 E Cook St
    CitySpringfield
    StateIL
    ZIP62703
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedOctober 13, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$32.5M
    Medicare$0

    Key Findings

    CENTRAL COUNTIES HEALTH CENTERS, INC. operates primarily as a Federally Qualified Health Center-style clinic network with heavy Medicaid activity and no Medicare billing on file; lifetime Medicaid revenue is $32.5M while Medicare shows none, indicating the organization is effectively single-payer (Medicaid)-focused in the available dataset. The NPI was enumerated on 2005-10-13 (~21 years ago), signaling long-standing participation in public programs and suggesting established clinic operations and patient panels. Revenue concentration is extreme: T1015, D0999, and T1040 together account for the vast majority of Medicaid revenue (precomputed top 3 codes account for 99.4% of total Medicaid revenue), with T1015 alone representing $26.4M (81.3% of Medicaid revenue), underlining a dependence on an all-inclusive clinic visit/encounter reimbursement model. T1015 ranks #22 of 846 providers in-state (98th percentile), so the provider is a major statewide participant for this code and delivers unusually high volume of comprehensive clinic encounters compared with peers. D0999 accounts for $5.3M (16.3% of Medicaid revenue) and ranks #2 of 219 providers in-state (100th percentile); this code’s classification as an extreme outlier indicates exceptionally high utilization of unspecified or miscellaneous dental/ancillary billing relative to other in-state providers. T1040 contributes $576.9K (1.8% of Medicaid revenue) for Medicaid certified community behavioral health clinic services and ranks #10 of 191 providers in-state (95th percentile), suggesting the organization also maintains a notable behavioral health per-diem service line alongside its primary clinic visit volume. The provider shows concentrated dental and preventive service activity in addition to medical/behavioral care: multiple dental codes (D0140, D1120, D7140, D0150, D1110 and others) appear in the top Medicaid codes with high in-state ranks (many in the 95th–100th percentiles), which implies an integrated oral health offering contributing smaller shares of revenue but high procedure volumes relative to peers. Several common outpatient and preventive codes (99213, 99214, 90832, 90471, D0220, D1206, 83036) appear with very high claim volumes but $0 paid/claim reported in the dataset; these entries are extreme outliers in rank and indicate widespread use of evaluation/management, behavioral health, immunization, radiology, preventive fluoride treatment, and A1C testing services, though they do not drive recorded Medicaid revenue in the provided payment fields. Overall, the billing profile indicates a clinic-centric operation with Medicaid as the primary payer, a concentrated revenue base around comprehensive clinic visit reimbursement (T1015) plus a substantial miscoded/unspecified dental category (D0999), and notable behavioral health per-diem activity (T1040); these patterns mark the provider as a dominant Medicaid Medicaid-volume player in several service lines within Illinois.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    115 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive209,550$130$26.4M
    D0999N/A50,950$100$5.3M
    T1040Medicaid certified community behavioral health clinic services, per diem7,490$80$576.9K
    D0140Limited oral evaluation – problem focused15,140$1$60.6K
    D1120Prophylaxis–child10,310$1$41.2K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)10,810$1$21.6K
    D0150Comprehensive oral evaluation – new or established patient6,150$1$18.4K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth2,710$1$10.8K
    D2392Post 2 surface resin‑based composite2,680$1$10.7K
    D2391Resin‑based composite – one surface, posterior1,970$1$5.9K

    Showing 1–10 of 115

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Illinois median

    115 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive228507,490$120$3.9M
    D0999N/A22201,090$110$610.1K
    D2930N/A74140190$160$180.3K
    87591The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.234360600$30$165.1K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.236360630$30$165K
    T1040Medicaid certified community behavioral health clinic services, per diem10190880$70$128.2K
    D1120Prophylaxis–child962,140960$40$89.1K
    D1351Sealant - per tooth4881,270530$60$87.1K
    D4341Periodontal scaling and root planing - four or more teeth per quadrant394510230$160$83.3K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.156740960$10$75.9K

    Showing 1–10 of 115

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    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Central Counties Health Centers, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jazzcelyn SchertzMOFamily Nurse Practitioner$99.6K$89.2K

    Nearby Providers

    Other providers in the same ZIP code as Central Counties Health Centers, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Springfield Clinic, LLPILClinical Medical Laboratory$3.5M$7.4M
    America Ambulance Service, Inc.ILAmbulance$1M$7.5M
    Gateway Foundation, Inc.ILSubstance Use Disorder Rehabilitation Clinic/Center$0$8.4M
    Aleksandr KaganILOphthalmology Physician$2.8M$1.5M
    Springfield Clinic LLPILAmbulatory Surgical Clinic/Center$3.5M$0
    Robert LowenthalILOphthalmology Physician$3.2M$62.6K
    Sangamon Area Special Education DistILLocal Education Agency (LEA)$0$2.9M
    Ramanath BhandariILOphthalmology Physician$2.5M$144.9K
    Joseph BaimaILDiagnostic Radiology Physician$217.4K$708.3K
    Edward HarterILDiagnostic Radiology Physician$242.8K$666.8K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Illinois Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Illinois Distribution
    Central Counties Health Centers, Inc. — 11 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Illinois