NPI: 1194179721 · EVANSTON, IL 60202 · Federally Qualified Health Center (FQHC) · NPI assigned 04/20/2016
Authorized official THOMPSON, DONNA controls 20+ related entities in our dataset. Read more
| Authorized Official | THOMPSON, DONNA (CEO) |
| NPI Enumeration Date | 04/20/2016 |
Other providers sharing the same authorized official: THOMPSON, DONNA
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 27,945 | $1.03M |
| 2019 | 53,907 | $1.50M |
| 2020 | 41,776 | $1.55M |
| 2021 | 39,189 | $1.47M |
| 2022 | 27,563 | $757K |
| 2023 | 44,295 | $1.43M |
| 2024 | 11,127 | $562K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 73,137 | 46,038 | $8.26M |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 380 | 248 | $15K |
| 90651 | 1,249 | 1,004 | $4K | |
| 90698 | 2,325 | 1,704 | $3K | |
| 90734 | 567 | 469 | $2K | |
| 90670 | 2,296 | 1,705 | $2K | |
| 90681 | 689 | 506 | $1K | |
| 90710 | 104 | 60 | $1K | |
| 90686 | 5,237 | 4,362 | $850.12 | |
| 0011A | 19 | 19 | $800.66 | |
| 90633 | 1,069 | 858 | $755.96 | |
| 90715 | 1,246 | 1,039 | $525.99 | |
| 90744 | 962 | 744 | $501.97 | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 27,978 | 19,429 | $333.22 |
| 3078F | 16,234 | 10,204 | $236.00 | |
| 3074F | 17,441 | 10,784 | $231.00 | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 8,974 | 6,584 | $139.00 |
| 90688 | 204 | 168 | $131.28 | |
| 90716 | 139 | 91 | $120.81 | |
| 1126F | 11,336 | 8,442 | $115.00 | |
| 3079F | 4,502 | 3,388 | $76.00 | |
| 90707 | 130 | 81 | $71.18 | |
| 3077F | 1,982 | 1,450 | $50.00 | |
| 3075F | 2,641 | 1,993 | $46.00 | |
| 1125F | 1,359 | 1,075 | $44.00 | |
| 3080F | 1,036 | 756 | $15.00 | |
| 90685 | 323 | 216 | $12.80 | |
| 81025 | 2,988 | 2,318 | $9.00 | |
| 81002 | 4,431 | 2,938 | $6.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5,414 | 4,068 | $3.01 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 547 | 430 | $3.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1,692 | 1,319 | $0.00 |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 68 | 56 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1,595 | 1,185 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3,217 | 2,554 | $0.00 |
| 0502F | 4,035 | 2,259 | $0.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11,137 | 6,869 | $0.00 |
| 90461 | 6,937 | 2,881 | $0.00 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2,664 | 2,004 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 827 | 681 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2,755 | 2,208 | $0.00 |
| 90832 | Psychotherapy, 30 minutes with patient | 2,619 | 956 | $0.00 |
| 90472 | Immunization administration, each additional vaccine (list separately) | 547 | 427 | $0.00 |
| 1160F | 64 | 42 | $0.00 | |
| 90621 | 54 | 54 | $0.00 | |
| 99215 | Prolong outpt/office vis | 140 | 122 | $0.00 |
| 1159F | 64 | 42 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 199 | 180 | $0.00 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 4,280 | 3,418 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2,587 | 2,132 | $0.00 |
| 99381 | 137 | 129 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 874 | 744 | $0.00 |
| 90677 | 79 | 43 | $0.00 | |
| S5190 | Wellness assessment, performed by non-physician | 113 | 111 | $0.00 |
| Q2036 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) | 28 | 28 | $0.00 |
| 59430 | 62 | 38 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 1,771 | 1,363 | $0.00 |
| 90656 | 161 | 161 | $0.00 | |
| 0500F | 77 | 72 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 30 | 30 | $0.00 |
| 90696 | 13 | 13 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 17 | 12 | $0.00 |
| 99384 | 20 | 16 | $0.00 |