Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC

NPI: 1225556996 · O FALLON, IL 62269 · Professional Counselor · NPI assigned 09/01/2017

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official MCCULLEY, LARRY controls 20+ related entities in our dataset. Read more

$7.91M
Total Medicaid Paid
138,807
Total Claims
102,101
Beneficiaries
53
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMCCULLEY, LARRY (CEO)
NPI Enumeration Date09/01/2017

Related Entities

Other providers sharing the same authorized official: MCCULLEY, LARRY

ProviderCityStateTotal Paid
SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC. ALTON IL $21.08M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. EAST ALTON IL $20.39M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC GRANITE CITY IL $20.37M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC CENTREVILLE IL $17.82M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC EAST ST LOUIS IL $12.04M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC BELLEVILLE IL $10.15M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. EAST SAINT LOUIS IL $9.77M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. SALEM IL $7.88M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. BELLEVILLE IL $6.30M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. OLNEY IL $6.27M
SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC. BELLEVILLE IL $5.24M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. COLLINSVILLE IL $4.70M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC EFFINGHAM IL $4.34M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. VANDALIA IL $2.58M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. BELLEVILLE IL $2.53M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC MATTOON IL $2.40M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. CHARLESTON IL $2.20M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. BUNKER HILL IL $1.99M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC. EAST SAINT LOUIS IL $1.63M
HERITAGE HILLS LLC PATTON MO $1.50M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 15,886 $795K
2019 25,132 $909K
2020 20,998 $1.31M
2021 17,863 $1.23M
2022 15,963 $1.23M
2023 17,112 $1.24M
2024 25,853 $1.19M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 62,963 43,176 $7.84M
T1040 Medicaid certified community behavioral health clinic services, per diem 899 600 $66K
90686 1,077 867 $784.41
90715 948 796 $468.12
90651 161 136 $437.62
90688 506 356 $404.77
90670 752 656 $211.51
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 253 187 $185.87
90734 65 56 $126.95
81025 1,082 801 $36.15
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 32,096 23,241 $31.01
83036 Hemoglobin; glycosylated (A1C) 1,560 1,449 $25.20
81003 630 512 $4.36
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,100 5,382 $0.00
96127 587 488 $0.00
90677 206 195 $0.00
90680 341 325 $0.00
1036F 2,437 2,149 $0.00
3075F 567 551 $0.00
90656 97 94 $0.00
3008F 3,616 3,240 $0.00
3079F 1,201 1,137 $0.00
S5190 Wellness assessment, performed by non-physician 297 235 $0.00
90698 121 107 $0.00
3074F 2,320 2,077 $0.00
0500F 26 26 $0.00
87428 37 36 $0.00
3080F 383 355 $0.00
90620 29 25 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 297 292 $0.00
90744 15 14 $0.00
3078F 1,820 1,637 $0.00
90837 Psychotherapy, 53 minutes with patient 990 638 $0.00
0502F 2,023 1,177 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,823 1,444 $0.00
90648 39 38 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 517 423 $0.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 889 639 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 84 81 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,147 956 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 503 416 $0.00
90832 Psychotherapy, 30 minutes with patient 1,559 937 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,912 2,478 $0.00
90633 64 52 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 84 80 $0.00
90791 Psychiatric diagnostic evaluation 86 67 $0.00
3725F 810 797 $0.00
3077F 519 481 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 182 122 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 21 13 $0.00
99215 Prolong outpt/office vis 28 28 $0.00
1160F 26 24 $0.00
81002 12 12 $0.00