Medicaid Provider Spending

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

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC

NPI: 1275561797 · BELLEVILLE, IL 62223 · Family Medicine Physician · NPI assigned 06/30/2006

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

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

$10.15M
Total Medicaid Paid
228,764
Total Claims
173,516
Beneficiaries
67
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMCCULLEY, LARRY (CHIEF EXECUTIVE OFFICER)
NPI Enumeration Date06/30/2006

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. EAST SAINT LOUIS IL $9.77M
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC O FALLON IL $7.91M
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 32,453 $1.48M
2019 56,895 $1.77M
2020 32,412 $1.78M
2021 44,224 $1.59M
2022 26,456 $1.37M
2023 12,238 $964K
2024 24,086 $1.20M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 83,589 59,160 $9.84M
D0999 Unspecified diagnostic procedure, by report 2,412 2,180 $267K
T1040 Medicaid certified community behavioral health clinic services, per diem 534 413 $37K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,304 1,827 $3K
90688 940 687 $578.02
90686 886 715 $572.55
90715 1,207 886 $256.98
82962 3,940 3,028 $139.94
0502F 7,603 4,010 $132.30
D1120 Prophylaxis - child 1,432 1,378 $129.15
D1206 Topical application of fluoride varnish 1,418 1,364 $81.90
D0150 Comprehensive oral evaluation - new or established patient 479 455 $78.24
96127 6,578 5,278 $66.00
81025 4,146 3,283 $38.74
D0272 Bitewings - two radiographic images 846 808 $22.18
81002 2,448 1,637 $18.20
Q0111 Wet mounts, including preparations of vaginal, cervical or skin specimens 1,384 930 $9.60
81003 3,998 2,363 $4.36
3078F 3,709 3,228 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 926 742 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 15,254 12,111 $0.00
90832 Psychotherapy, 30 minutes with patient 4,676 3,064 $0.00
3725F 2,853 2,580 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 33 32 $0.00
90837 Psychotherapy, 53 minutes with patient 261 174 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 2,004 1,655 $0.00
3077F 1,256 1,156 $0.00
99215 Prolong outpt/office vis 148 135 $0.00
1160F 5,439 4,548 $0.00
D0220 Intraoral - periapical first radiographic image 265 256 $0.00
90687 118 48 $0.00
D0274 Bitewings - four radiographic images 65 58 $0.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 123 91 $0.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 352 289 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 40 25 $0.00
82948 49 43 $0.00
99201 29 13 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 30 12 $0.00
90791 Psychiatric diagnostic evaluation 24 24 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 14 13 $0.00
0500F 870 705 $0.00
0503F 711 512 $0.00
S5190 Wellness assessment, performed by non-physician 689 601 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 5,319 4,446 $0.00
D0120 Periodic oral evaluation - established patient 991 958 $0.00
3008F 7,726 6,658 $0.00
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 31,414 23,845 $0.00
3080F 1,024 926 $0.00
3075F 1,365 1,257 $0.00
83036 Hemoglobin; glycosylated (A1C) 195 154 $0.00
D1351 Sealant - per tooth 93 53 $0.00
3074F 4,868 4,202 $0.00
3079F 2,752 2,499 $0.00
90792 Psychiatric diagnostic evaluation with medical services 469 383 $0.00
99385 211 189 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 225 222 $0.00
1036F 5,355 4,582 $0.00
1126F 115 114 $0.00
D0230 Intraoral - periapical each additional radiographic image 45 41 $0.00
99386 31 27 $0.00
90651 40 26 $0.00
D7140 Extraction, erupted tooth or exposed root 17 15 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 46 43 $0.00
1125F 184 167 $0.00
90656 102 99 $0.00
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 79 78 $0.00
D0140 Limited oral evaluation - problem focused 16 15 $0.00