CRUSADERS CENTRAL CLINIC ASSOCIATION

NPI: 1346762390 · SOUTH BELOIT, IL 61080 · Federally Qualified Health Center (FQHC) · NPI assigned 07/12/2017

$8K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-01

First Month

2018-02

Last Month

Provider Details

Authorized Official	MILLER, SAMUEL (PRESDIENT & CEO)
Parent Organization	CRUSADERS CENTRAL CLINIC ASSOCIATION
NPI Enumeration Date	07/12/2017

Other providers sharing the same authorized official: MILLER, SAMUEL

Provider	City	State	Total Paid
CRUSADERS CENTRAL CLINIC ASSOCIATION	ROCKFORD	IL	$62.78M
CRUSADERS CENTRAL CLINIC ASSOCIATION	ROCKFORD	IL	$38.86M
CRUSADERS CENTRAL CLINIC ASSOCIATION	ROCKFORD	IL	$16.42M
CRUSADERS CENTRAL CLINIC ASSOCIATION	BELVIDERE	IL	$10.57M
CRUSADERS CENTRAL CLINIC ASSOCIATION	LOVES PARK	IL	$10.54M
CRUSADERS CENTRAL CLINIC ASSOCIATION	SOUTH BELOIT	IL	$182K
CRUSADERS CENTRAL CLINIC ASSOCIATION	ROCKFORD	IL	$42K
CRUSADERS CENTRAL CLINIC ASSOCIATION	ROCKFORD	IL	$6K
NORTH SUNFLOWER MEDICAL CENTER	GREENWOOD	MS	$3K

Year	Claims	Total Paid
2018	80	$8K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	66	56	$8K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	14	14	$0.00