Medicaid Provider Spending

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

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

NPI: 1376588871 · BELLEVILLE, IL 62223 · Pediatrics Physician · NPI assigned 06/18/2006

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

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

$6.30M
Total Medicaid Paid
173,612
Total Claims
140,414
Beneficiaries
56
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMCCULLEY, LARRY (CEO)
NPI Enumeration Date06/18/2006

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 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. 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 16,628 $691K
2019 37,947 $864K
2020 17,391 $704K
2021 31,070 $897K
2022 21,797 $896K
2023 16,245 $883K
2024 32,534 $1.36M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 45,937 34,694 $6.22M
T1040 Medicaid certified community behavioral health clinic services, per diem 1,004 772 $75K
90651 1,951 1,623 $1K
90670 4,649 3,783 $1K
90723 2,937 2,475 $279.95
90686 3,943 3,359 $270.84
90734 1,629 1,339 $257.70
90633 3,092 2,626 $244.27
90716 1,192 990 $122.02
90648 1,546 1,074 $109.63
90700 1,343 1,145 $66.44
36416 2,318 1,921 $20.50
92551 2,568 1,699 $15.20
96127 3,443 2,650 $11.00
99173 5,993 4,781 $7.45
S5190 Wellness assessment, performed by non-physician 557 531 $6.59
81002 153 106 $5.20
96110 Developmental screening, with scoring and documentation, per standardized instrument 5,380 4,351 $0.00
99381 1,155 1,021 $0.00
90647 1,966 1,815 $0.00
90697 746 695 $0.00
1036F 3,156 2,778 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 742 690 $0.00
90696 1,000 848 $0.00
3074F 4,501 4,025 $0.00
3008F 8,045 7,014 $0.00
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 10,733 8,714 $0.00
3079F 83 71 $0.00
90656 483 426 $0.00
90677 732 673 $0.00
90620 390 311 $0.00
90698 521 317 $0.00
87428 72 72 $0.00
90381 62 53 $0.00
99383 17 16 $0.00
83036 Hemoglobin; glycosylated (A1C) 49 45 $0.00
1160F 4,425 3,591 $0.00
90832 Psychotherapy, 30 minutes with patient 3,656 2,276 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 3,197 2,684 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 5,478 4,637 $0.00
90681 2,507 2,090 $0.00
3725F 1,584 1,426 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 237 224 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 7,510 6,268 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,921 4,215 $0.00
90715 935 773 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 6,769 5,535 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 168 159 $0.00
90707 1,194 995 $0.00
90791 Psychiatric diagnostic evaluation 229 224 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 805 659 $0.00
90710 1,335 1,122 $0.00
3078F 4,277 3,838 $0.00
90837 Psychotherapy, 53 minutes with patient 232 134 $0.00
90380 35 34 $0.00
81003 30 27 $0.00