Clinic
Southern Illinois Medical Services, NFP
Southern Illinois Medical Services, NFP was paid $15.18M by Medicaid between Jan 2018 and Dec 2024, across 68 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider infoSOUTHERN ILLINOIS MEDICAL SERVICES, NFP
CARBONDALE, IL 62901
CARBONDALE, IL 62901
33aNPI1154510808assigned 10/18/2007
33bProvider typeRural Health Clinic/Center
28Total paid$15.18M
24GClaims438,883
24DCodes billed68
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Illinois
Rank by total paid#3 of 235
Median peer was paid$611K
This provider vs. median25×
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 | 37,694 | $1.38M | |
| 2019 | 88,881 | $2.24M | |
| 2020 | 64,734 | $2.33M | |
| 2021 | 60,750 | $2.16M | |
| 2022 | 73,376 | $2.69M | |
| 2023 | 63,442 | $2.40M | |
| 2024incomplete | 50,006 | $1.99M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 180,072 | 133,236 | $15.12M |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | <1% | 1,172 | 807 | $69K |
| S5190 | Wellness assessment, performed by non-physician | <1% | 845 | 790 | $92.30 |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 2,029 | 1,652 | $72.72 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 53,794 | 43,410 | $48.89 |
| 90647 | 0% | 3,697 | 3,469 | $0.00 | |
| 90723 | 0% | 3,677 | 3,510 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 1,932 | 1,541 | $0.00 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | 0% | 502 | 440 | $0.00 |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 0% | 60,834 | 47,959 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 5,079 | 4,587 | $0.00 |
| 90656 | 0% | 401 | 367 | $0.00 |
56 more codes
| 90686 | 0% | 3,488 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 2,027 | $0.00 |
| 90716 | 0% | 1,094 | $0.00 | |
| 87807 | 0% | 1,804 | $0.00 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 659 | $0.00 |
| 90696 | 0% | 862 | $0.00 | |
| 90651 | 0% | 732 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 0% | 69 | $0.00 |
| 90677 | 0% | 41 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 0% | 381 | $0.00 |
| 90474 | 0% | 296 | $0.00 | |
| 90732 | 0% | 36 | $0.00 | |
| 90620 | 0% | 47 | $0.00 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 0% | 49 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 12 | $0.00 |
| 99384 | 0% | 18 | $0.00 | |
| 99383 | 0% | 77 | $0.00 | |
| 99381 | 0% | 29 | $0.00 | |
| 99406 | 0% | 13 | $0.00 | |
| J8540 | Dexamethasone, oral, 0.25 mg | 0% | 16 | $0.00 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | 0% | 17 | $0.00 |
| 99205 | Prolong outpt/office vis | 0% | 15 | $0.00 |
| 81002 | 0% | 4,212 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 17,089 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 10,489 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 4,721 | $0.00 |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 2,221 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 3,600 | $0.00 |
| 90681 | 0% | 2,277 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 3,440 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 13,109 | $0.00 |
| 90461 | 0% | 11,089 | $0.00 | |
| 90670 | 0% | 4,075 | $0.00 | |
| 90710 | 0% | 1,158 | $0.00 | |
| 90715 | 0% | 964 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 2,342 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 11,480 | $0.00 |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 1,759 | $0.00 |
| 90633 | 0% | 2,425 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 402 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 6,600 | $0.00 |
| 81025 | 0% | 678 | $0.00 | |
| 90734 | 0% | 1,070 | $0.00 | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 0% | 421 | $0.00 |
| 90707 | 0% | 1,040 | $0.00 | |
| 90700 | 0% | 1,290 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 1,584 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 273 | $0.00 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 2,892 | $0.00 |
| 69209 | 0% | 12 | $0.00 | |
| 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 established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 104 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 15 | $0.00 |
| 90837 | Psychotherapy session, about an hour | 0% | 155 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 37 | $0.00 |
| 95251 | 0% | 27 | $0.00 | |
| 99382 | 0% | 17 | $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 officialLADNER, WARREN (SENIOR VP CHIEF FINANCIAL OFFICER)
Parent organizationSOUTHERN ILLINOIS HOSPITAL SERVICES
| Provider | Location | Paid |
|---|---|---|
| Southern Illinois Medical Services, NFP | Harrisburg, IL | $12.43M |
| Southern Illinois Medical Services, NFP | Herrin, IL | $9.14M |
| Southern Illinois Medical Services, NFP | West Frankfort, IL | $4.61M |
| Harrisburg Medical Center INC | Marion, IL | $2.19M |
| Southern Illinois Hospital Services | West Frankfort, IL | $1.90M |
| Southern Illinois Medical Services, NFP | Murphysboro, IL | $1.36M |
| Southern Illinois Medical Services, NFP | Benton, IL | $1.28M |
| Harrisburg Medical Center INC | Eldorado, IL | $924K |
| Harrisburg Medical Center INC | Harrisburg, IL | $280K |
| Southern Illinois Medical Services, NFP | Anna, IL | $248K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.