The Carle Foundation Hospital
The Carle Foundation Hospital was paid $830K by Medicaid between Apr 2018 and Jan 2022, across 144 billing codes. Its largest line is 97110, Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion — 49% of everything it billed.
33Billing provider infoTHE CARLE FOUNDATION HOSPITAL
URBANA, IL 61801
URBANA, IL 61801
33aNPI1013071653assigned 12/20/2006
33bProvider typeOccupational Therapist
28Total paid$830K
24GClaims27,704
24DCodes billed144
24AFirst – last monthApr 2018 – Jan 2022
Compared with peers
Next to other Occupational Therapist providers in Illinois
Rank by total paid#12 of 289
Median peer was paid$24K
This provider vs. median34×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 25,136 | $640K | |
| 2019 | 843 | $121K | |
| 2020 | 1,705 | $68K | |
| 2022 | 20 | $852.93 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 49% | 4,569 | 784 | $407K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 14% | 831 | 467 | $116K |
| 97162 | 7.9% | 582 | 258 | $66K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | 3.3% | 188 | 185 | $27K |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | 2.3% | 938 | 196 | $19K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.5% | 51 | 50 | $13K |
| 90670 | 1.5% | 420 | 391 | $12K | |
| 90651 | 1.4% | 231 | 183 | $12K | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 1.3% | 626 | 355 | $11K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 1.3% | 627 | 356 | $10K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 1.0% | 120 | 107 | $9K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 57 | 44 | $8K |
132 more codes
| 90791 | Psychiatric diagnostic evaluation | <1% | 31 | $7K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 171 | $6K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 799 | $6K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 103 | $5K |
| 90710 | <1% | 144 | $5K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 309 | $5K |
| 80053 | Comprehensive metabolic panel | <1% | 1,185 | $4K |
| 97163 | <1% | 32 | $4K | |
| 17110 | <1% | 51 | $4K | |
| 90734 | <1% | 194 | $3K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 72 | $3K |
| 90715 | <1% | 274 | $3K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 581 | $3K |
| 87536 | <1% | 38 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 408 | $3K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | <1% | 97 | $2K |
| 90732 | <1% | 29 | $2K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 122 | $2K |
| 0502F | <1% | 60 | $2K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 394 | $2K |
| 87081 | <1% | 355 | $2K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,337 | $2K |
| 90686 | <1% | 165 | $2K | |
| 92015 | Determination of refractive state | <1% | 341 | $2K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 47 | $1K |
| 92551 | <1% | 98 | $1K | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 187 | $1K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 129 | $1K |
| 90723 | <1% | 323 | $1K | |
| 86480 | <1% | 35 | $1K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 301 | $1K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 99 | $1K |
| 90681 | <1% | 158 | $1K | |
| 73630 | <1% | 93 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 535 | $1K |
| 97161 | <1% | 19 | $1K | |
| 99173 | <1% | 157 | $967.50 | |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 20 | $852.93 |
| 90633 | <1% | 224 | $852.34 | |
| 82784 | <1% | 71 | $844.44 | |
| 85610 | <1% | 266 | $775.73 | |
| 73610 | <1% | 56 | $774.90 | |
| 80061 | Lipid panel | <1% | 432 | $765.28 |
| 87808 | <1% | 171 | $762.36 | |
| 84702 | <1% | 130 | $747.51 | |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision | <1% | 316 | $736.99 |
| 90716 | <1% | 57 | $711.82 | |
| 90647 | <1% | 258 | $687.09 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 67 | $680.33 |
| G0432 | Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening | <1% | 344 | $680.31 |
| 86803 | <1% | 151 | $633.10 | |
| 72110 | <1% | 37 | $625.35 | |
| 83655 | <1% | 101 | $603.00 | |
| 87186 | <1% | 113 | $595.82 | |
| 73560 | <1% | 41 | $558.60 | |
| 94060 | <1% | 29 | $544.33 | |
| 87340 | <1% | 187 | $536.40 | |
| 81002 | <1% | 294 | $533.17 | |
| 80074 | <1% | 22 | $499.20 | |
| 73110 | <1% | 42 | $477.30 | |
| 82728 | <1% | 286 | $472.21 | |
| 87905 | <1% | 158 | $453.62 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 39 | $450.76 |
| 84466 | <1% | 191 | $439.80 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 18 | $425.50 |
| 84439 | <1% | 183 | $363.08 | |
| 82607 | <1% | 169 | $322.02 | |
| 81025 | <1% | 237 | $298.82 | |
| 86038 | <1% | 75 | $261.62 | |
| 92134 | <1% | 15 | $260.20 | |
| 87088 | <1% | 40 | $239.48 | |
| 73130 | <1% | 23 | $237.90 | |
| 92567 | <1% | 28 | $221.30 | |
| 90696 | <1% | 77 | $217.09 | |
| 87077 | <1% | 69 | $194.70 | |
| 85027 | <1% | 139 | $178.75 | |
| 86592 | <1% | 302 | $174.49 | |
| 69210 | <1% | 13 | $171.20 | |
| 90700 | <1% | 61 | $164.45 | |
| 86901 | <1% | 124 | $164.11 | |
| 90707 | <1% | 38 | $147.55 | |
| 73030 | <1% | 13 | $144.30 | |
| 81001 | <1% | 280 | $142.52 | |
| 83540 | <1% | 202 | $139.68 | |
| 86140 | <1% | 140 | $138.98 | |
| 83516 | <1% | 44 | $131.70 | |
| 88720 | <1% | 32 | $129.80 | |
| 73140 | <1% | 19 | $129.04 | |
| 83735 | <1% | 112 | $117.18 | |
| 82570 | <1% | 117 | $116.24 | |
| Q0111 | Wet mounts, including preparations of vaginal, cervical or skin specimens | <1% | 36 | $110.27 |
| 87070 | <1% | 46 | $105.40 | |
| 74018 | <1% | 12 | $101.90 | |
| 95117 | <1% | 24 | $99.60 | |
| 80305 | <1% | 13 | $98.78 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 17 | $98.77 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 30 | $96.19 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 172 | $80.90 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 75 | $73.52 |
| 80076 | <1% | 18 | $71.82 | |
| 82950 | <1% | 78 | $68.99 | |
| 86850 | <1% | 104 | $67.35 | |
| G0009 | Administration of pneumococcal vaccine | <1% | 29 | $62.98 |
| 82043 | <1% | 66 | $55.16 | |
| 85652 | <1% | 132 | $52.05 | |
| 86696 | <1% | 34 | $42.65 | |
| 86762 | <1% | 86 | $40.34 | |
| 84550 | <1% | 43 | $39.54 | |
| 86360 | <1% | 38 | $38.02 | |
| 83721 | <1% | 134 | $37.36 | |
| 83615 | <1% | 50 | $35.36 | |
| 87210 | <1% | 121 | $32.90 | |
| 87205 | <1% | 45 | $28.00 | |
| 83986 | <1% | 14 | $24.64 | |
| 90461 | <1% | 93 | $24.45 | |
| 86900 | <1% | 121 | $24.22 | |
| 86359 | <1% | 38 | $22.32 | |
| 86200 | <1% | 21 | $21.70 | |
| 83690 | <1% | 16 | $20.16 | |
| Q0112 | All potassium hydroxide (koh) preparations | <1% | 15 | $19.20 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 224 | $16.18 |
| 85018 | <1% | 15 | $13.92 | |
| 84156 | <1% | 22 | $6.90 | |
| 86695 | <1% | 34 | $5.81 | |
| 85014 | <1% | 14 | $4.64 | |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 39 | $2.10 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 50 | $1.95 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 33 | $0.14 |
| 36416 | 0% | 22 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 92 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 18 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 34 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLEONARD, JAMES (CEO)
| Provider | Location | Paid |
|---|---|---|
| Carle Foundation Hospital | Urbana, IL | $8.32M |
| The Carle Foundation Hospital | Champaign, IL | $6.36M |
| The Carle Foundation Hospital | Champaign, IL | $4.77M |
| The Carle Foundation Hospital | Urbana, IL | $2.52M |
| The Carle Foundation Hospital | Danville, IL | $1.29M |
| The Carle Foundation Hospital | Mattoon, IL | $457K |
| The Carle Foundation Hospital | Normal, IL | $4K |
| Carle Health Care Incorporated | Champaign, IL | $681.19 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.