NPI: 1407376338 · DECATUR, IL 62526 · Primary Care Clinic/Center · NPI assigned 06/21/2017
Authorized official WESLEY, IRIS controls 19+ related entities in our dataset. Read more
| Authorized Official | WESLEY, IRIS (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY |
| NPI Enumeration Date | 06/21/2017 |
Other providers sharing the same authorized official: WESLEY, IRIS
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 23,807 | $772K |
| 2019 | 27,669 | $909K |
| 2020 | 18,810 | $946K |
| 2021 | 24,793 | $1.48M |
| 2022 | 24,921 | $1.60M |
| 2023 | 22,958 | $1.56M |
| 2024 | 16,581 | $1.34M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 74,958 | 51,431 | $8.44M |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 2,133 | 1,084 | $164K |
| 0011A | 115 | 114 | $5K | |
| 0012A | 108 | 108 | $5K | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 10,198 | 8,151 | $383.54 |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 36,365 | 26,046 | $289.95 |
| 90670 | 1,662 | 1,178 | $205.88 | |
| 90834 | Psychotherapy, 45 minutes with patient | 3,049 | 1,561 | $142.01 |
| 90680 | 645 | 463 | $108.77 | |
| 90723 | 1,196 | 850 | $107.10 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 186 | 150 | $64.46 |
| 90648 | 1,534 | 1,084 | $48.10 | |
| 0502F | 439 | 243 | $44.38 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2,610 | 1,970 | $32.32 |
| 90633 | 619 | 481 | $25.67 | |
| 90686 | 2,596 | 1,866 | $25.66 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 3,145 | 2,535 | $18.58 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 210 | 145 | $15.75 |
| 96127 | 2,215 | 2,027 | $14.62 | |
| 81003 | 2,891 | 2,074 | $12.74 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2,055 | 1,505 | $0.38 |
| 90716 | 657 | 481 | $0.09 | |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1,902 | 1,654 | $0.06 |
| 90651 | 484 | 357 | $0.06 | |
| 90707 | 634 | 469 | $0.05 | |
| 90715 | 589 | 423 | $0.04 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1,423 | 1,107 | $0.03 |
| 81025 | 240 | 198 | $0.02 | |
| 90734 | 393 | 265 | $0.02 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 836 | 664 | $0.01 |
| 90619 | 22 | 21 | $0.01 | |
| 90832 | Psychotherapy, 30 minutes with patient | 650 | 431 | $0.00 |
| 90837 | Psychotherapy, 53 minutes with patient | 306 | 157 | $0.00 |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 573 | 454 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 505 | 447 | $0.00 |
| 83655 | 14 | 14 | $0.00 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 33 | 28 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 57 | 50 | $0.00 |
| 90700 | 18 | 12 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 176 | 162 | $0.00 |
| 90656 | 95 | 92 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 393 | 285 | $0.00 |
| 82044 | 125 | 116 | $0.00 | |
| 90696 | 186 | 137 | $0.00 | |
| 99383 | 60 | 43 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 59 | 59 | $0.00 |
| 82962 | 26 | 12 | $0.00 | |
| 93000 | 27 | 14 | $0.00 | |
| 99384 | 41 | 23 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 24 | 12 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 46 | 32 | $0.00 |
| 99381 | 16 | 16 | $0.00 |