Medicaid Provider Spending

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

SOUTHERN ILLINOIS HEALTH CARE FOUNDATION, INC.

NPI: 1376589226 · ALTON, IL 62002 · Professional Counselor · NPI assigned 06/21/2006

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

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

$21.08M
Total Medicaid Paid
449,591
Total Claims
335,670
Beneficiaries
88
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMCCULLEY, LARRY (PRESIDENT/CEO)
NPI Enumeration Date06/21/2006

Related Entities

Other providers sharing the same authorized official: MCCULLEY, LARRY

ProviderCityStateTotal Paid
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. 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 44,124 $2.10M
2019 113,658 $3.48M
2020 62,145 $3.34M
2021 51,058 $2.94M
2022 49,936 $2.93M
2023 52,088 $2.98M
2024 76,582 $3.30M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 167,248 114,706 $20.89M
T1040 Medicaid certified community behavioral health clinic services, per diem 2,362 1,577 $175K
90651 2,112 1,757 $3K
59430 204 169 $3K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2,224 2,096 $3K
0503F 1,926 1,451 $2K
90670 3,085 2,541 $1K
90734 1,438 1,166 $969.27
90620 674 541 $679.40
90688 1,982 1,285 $614.66
90698 2,281 1,789 $374.14
S5190 Wellness assessment, performed by non-physician 1,786 1,661 $238.51
90686 2,849 2,371 $234.20
90715 2,506 2,081 $232.25
90710 1,249 1,024 $208.81
81025 4,832 4,099 $176.36
90633 1,922 1,637 $141.78
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 59,083 43,887 $139.94
86580 966 775 $120.00
90732 29 13 $105.00
90680 675 482 $82.89
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 14 13 $64.40
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 7,409 5,892 $62.80
90834 Psychotherapy, 45 minutes with patient 3,026 2,004 $62.01
90696 441 348 $57.10
81003 11,083 7,705 $32.70
90744 1,356 1,052 $26.14
81002 5,138 3,075 $7.80
83036 Hemoglobin; glycosylated (A1C) 2,127 1,727 $6.30
82962 525 287 $1.68
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 58 53 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 3,455 2,947 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,831 3,262 $0.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,586 1,228 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 3,539 3,068 $0.00
0502F 11,838 6,547 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,725 2,277 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 20,440 16,702 $0.00
90832 Psychotherapy, 30 minutes with patient 8,508 5,246 $0.00
H1000 Prenatal care, at-risk assessment 394 318 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 1,850 1,562 $0.00
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 814 563 $0.00
3725F 3,002 2,870 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3,932 3,217 $0.00
3078F 5,507 4,856 $0.00
90837 Psychotherapy, 53 minutes with patient 2,328 1,466 $0.00
90681 899 797 $0.00
90700 103 99 $0.00
90791 Psychiatric diagnostic evaluation 930 690 $0.00
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,010 1,796 $0.00
3077F 1,014 934 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 1,591 1,524 $0.00
1160F 187 175 $0.00
99215 Prolong outpt/office vis 39 38 $0.00
90472 Immunization administration, each additional vaccine (list separately) 50 50 $0.00
90707 126 103 $0.00
90672 31 30 $0.00
90648 43 42 $0.00
96127 13,881 11,210 $0.00
92551 621 357 $0.00
3080F 855 786 $0.00
99383 67 67 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 2,979 2,874 $0.00
90677 429 408 $0.00
87428 1,120 1,068 $0.00
3079F 2,716 2,487 $0.00
90792 Psychiatric diagnostic evaluation with medical services 1,154 842 $0.00
90656 348 326 $0.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 4,732 3,778 $0.00
3074F 6,876 5,955 $0.00
99381 328 288 $0.00
0500F 1,629 1,429 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 17,511 13,865 $0.00
3075F 1,188 1,132 $0.00
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 109 70 $0.00
90697 785 759 $0.00
3008F 9,754 8,328 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 36 27 $0.00
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 507 380 $0.00
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 786 760 $0.00
J0561 Injection, penicillin g benzathine, 100,000 units 134 107 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,012 981 $0.00
1036F 6,177 5,284 $0.00
90716 131 108 $0.00
87807 109 99 $0.00
99384 33 32 $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 182 179 $0.00
Q3014 Telehealth originating site facility fee 20 13 $0.00