CRUSADERS CENTRAL CLINIC ASSOCIATION

NPI: 1417203191 · ROCKFORD, IL 61102 · Federally Qualified Health Center (FQHC) · NPI assigned 07/31/2012

$6K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-10

First Month

2019-08

Last Month

Provider Details

Authorized Official	MILLER, SAMUEL (PRESIDENT AND CEO)
Parent Organization	CRUSADERS CENTRAL CLINIC ASSOCIATION
NPI Enumeration Date	07/31/2012

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	SOUTH BELOIT	IL	$8K
NORTH SUNFLOWER MEDICAL CENTER	GREENWOOD	MS	$3K

Year	Claims	Total Paid
2018	34	$647.02
2019	42	$5K

Code	Claims	Beneficiaries	Total Paid
90651	13	13	$3K
90734	17	17	$2K
90686	34	34	$647.02
90715	12	12	$384.60