Medicaid Provider Spending

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

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC

NPI: 1326392747 · GRANITE CITY, IL 62040 · Counselor · NPI assigned 11/07/2012

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

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

$20.37M
Total Medicaid Paid
457,741
Total Claims
348,148
Beneficiaries
104
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMCCULLEY, LARRY (CEO)
NPI Enumeration Date11/07/2012

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 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 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 55,500 $2.33M
2019 110,789 $2.83M
2020 72,103 $3.43M
2021 60,883 $3.03M
2022 45,851 $2.90M
2023 47,549 $2.95M
2024 65,066 $2.91M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 152,210 107,639 $19.02M
D0999 Unspecified diagnostic procedure, by report 8,195 7,619 $994K
T1040 Medicaid certified community behavioral health clinic services, per diem 4,384 3,279 $324K
90651 2,970 2,379 $17K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 6,253 4,773 $9K
90688 1,702 1,231 $2K
90670 3,603 2,903 $1K
81025 8,167 6,191 $1K
90716 670 542 $527.52
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 2,171 1,575 $425.85
90710 1,043 847 $417.62
90734 1,614 1,349 $393.65
90715 2,937 2,356 $358.09
90686 4,069 3,413 $334.65
S5190 Wellness assessment, performed by non-physician 3,127 2,750 $294.30
90707 664 522 $290.18
90633 2,441 2,047 $198.58
90698 2,987 2,370 $188.98
90620 298 242 $165.75
96127 19,523 13,289 $157.60
90696 789 632 $116.14
0502F 7,871 4,217 $88.20
87428 207 199 $63.00
81003 14,783 9,537 $52.55
83036 Hemoglobin; glycosylated (A1C) 2,605 1,978 $37.80
90744 1,302 1,016 $26.14
G8510 Screening for depression is documented as negative, a follow-up plan is not required 2,577 2,467 $22.00
86580 42 30 $20.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 1,129 1,051 $11.00
90681 1,723 1,399 $6.40
81002 988 744 $2.60
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 14,427 11,368 $0.00
90832 Psychotherapy, 30 minutes with patient 14,360 8,409 $0.00
D1120 Prophylaxis - child 4,986 4,847 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 4,795 3,771 $0.00
D0274 Bitewings - four radiographic images 793 758 $0.00
3077F 729 685 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 806 700 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 5,379 4,482 $0.00
H1000 Prenatal care, at-risk assessment 395 299 $0.00
99173 4,167 3,276 $0.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 808 684 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 227 215 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 4,593 3,799 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 3,304 2,752 $0.00
90791 Psychiatric diagnostic evaluation 211 191 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 627 600 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,133 1,704 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 243 237 $0.00
99201 184 136 $0.00
3078F 4,961 4,562 $0.00
90685 40 36 $0.00
1160F 1,407 1,281 $0.00
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 184 174 $0.00
3725F 3,555 3,272 $0.00
D2391 Resin-based composite - one surface, posterior, primary or permanent 45 41 $0.00
90648 262 185 $0.00
99177 72 62 $0.00
11982 13 13 $0.00
D2140 78 57 $0.00
96160 31 29 $0.00
90658 96 89 $0.00
D0220 Intraoral - periapical first radiographic image 43 42 $0.00
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month 315 231 $0.00
90380 13 12 $0.00
90687 15 15 $0.00
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 20 20 $0.00
99215 Prolong outpt/office vis 12 12 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 12,671 10,718 $0.00
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 195 170 $0.00
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 61,654 46,823 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 5,388 4,286 $0.00
D7140 Extraction, erupted tooth or exposed root 236 193 $0.00
1036F 4,973 4,529 $0.00
D1206 Topical application of fluoride varnish 5,005 4,867 $0.00
90723 171 123 $0.00
99381 545 473 $0.00
0500F 963 746 $0.00
90834 Psychotherapy, 45 minutes with patient 2,379 1,512 $0.00
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 28 26 $0.00
D0120 Periodic oral evaluation - established patient 3,875 3,764 $0.00
0503F 476 329 $0.00
3080F 464 437 $0.00
D0150 Comprehensive oral evaluation - new or established patient 1,053 1,024 $0.00
3074F 5,573 5,104 $0.00
3075F 880 844 $0.00
D0272 Bitewings - two radiographic images 974 941 $0.00
99383 240 180 $0.00
D1351 Sealant - per tooth 44 16 $0.00
90677 560 517 $0.00
D0140 Limited oral evaluation - problem focused 177 158 $0.00
3079F 1,832 1,744 $0.00
3008F 7,790 7,098 $0.00
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 978 754 $0.00
99384 115 104 $0.00
87807 38 36 $0.00
90697 477 456 $0.00
90656 386 337 $0.00
36415 Collection of venous blood by venipuncture 13 13 $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 112 110 $0.00
D9995 50 34 $0.00
90792 Psychiatric diagnostic evaluation with medical services 15 15 $0.00
99205 Prolong outpt/office vis 22 22 $0.00
Q3014 Telehealth originating site facility fee 16 13 $0.00