DEACONESS ILLINOIS CROSSROADS INC
NPI: 1316663602
· MOUNT VERNON, IL 62864
· Rural Health Clinic/Center
· NPI assigned 10/18/2022
$335K
Total Medicaid Paid
Provider Details
| Authorized Official | LIPE, AMBER (CFO) |
| NPI Enumeration Date | 10/18/2022 |
Related Entities
Other providers sharing the same authorized official: LIPE, AMBER
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
5,309 |
$196K |
| 2024 |
3,365 |
$139K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,941 |
4,306 |
$335K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
27 |
$0.00 |
| 1159F |
|
143 |
130 |
$0.00 |
| 1160F |
|
141 |
128 |
$0.00 |
| 3725F |
|
65 |
58 |
$0.00 |
| 3078F |
|
39 |
39 |
$0.00 |
| 3288F |
|
18 |
15 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,124 |
962 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,021 |
1,813 |
$0.00 |
| 3074F |
|
61 |
58 |
$0.00 |
| 1036F |
|
40 |
39 |
$0.00 |
| 1126F |
|
53 |
51 |
$0.00 |