Medicaid Provider Spending

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

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

NPI: 1811054935 · EAST SAINT LOUIS, IL 62205 · Family Medicine Physician · NPI assigned 01/02/2007

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

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

$9.77M
Total Medicaid Paid
211,725
Total Claims
171,315
Beneficiaries
74
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMCCULLEY, LARRY (CHIEF OPERATING OFFICER)
NPI Enumeration Date01/02/2007

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 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 17,466 $884K
2019 43,423 $1.24M
2020 23,912 $1.43M
2021 33,978 $1.54M
2022 25,135 $1.35M
2023 20,797 $1.32M
2024 47,014 $1.99M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 72,265 56,205 $9.76M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 700 622 $303.59
81025 1,549 1,180 $300.52
90651 1,496 1,226 $218.81
90688 440 263 $53.52
96127 3,137 2,425 $36.60
90715 1,019 814 $33.10
81003 2,967 1,968 $28.34
90686 2,303 1,993 $19.58
90672 100 76 $12.80
83036 Hemoglobin; glycosylated (A1C) 712 467 $12.60
90734 1,162 942 $6.40
86580 191 169 $4.00
96110 Developmental screening, with scoring and documentation, per standardized instrument 3,953 3,198 $0.00
90620 599 474 $0.00
36416 715 558 $0.00
3074F 4,527 4,054 $0.00
3079F 1,931 1,798 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 987 936 $0.00
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 19,066 15,542 $0.00
3075F 788 760 $0.00
87428 445 439 $0.00
92551 1,569 987 $0.00
1125F 583 552 $0.00
1036F 4,888 4,326 $0.00
90697 295 288 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,732 1,476 $0.00
90723 365 305 $0.00
90677 209 199 $0.00
3080F 1,061 1,006 $0.00
3008F 7,961 7,115 $0.00
1126F 2,300 2,174 $0.00
90716 619 350 $0.00
S5190 Wellness assessment, performed by non-physician 250 216 $0.00
36415 Collection of venous blood by venipuncture 67 62 $0.00
90696 519 380 $0.00
90698 221 188 $0.00
90632 13 13 $0.00
90744 59 43 $0.00
82962 222 160 $0.00
90656 273 241 $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 39 38 $0.00
99381 43 38 $0.00
99383 14 14 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 23 22 $0.00
3044F 14 13 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 3,906 3,240 $0.00
90670 2,186 1,765 $0.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 25,489 20,192 $0.00
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 578 521 $0.00
90710 980 868 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 750 676 $0.00
0502F 1,322 670 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 2,987 2,537 $0.00
90681 252 212 $0.00
3078F 3,885 3,489 $0.00
90633 1,707 1,361 $0.00
90648 919 670 $0.00
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,904 1,606 $0.00
99173 5,613 4,593 $0.00
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3,440 2,704 $0.00
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 224 200 $0.00
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 623 477 $0.00
3077F 1,539 1,448 $0.00
90707 648 370 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 285 276 $0.00
3725F 4,035 3,750 $0.00
90700 178 137 $0.00
1160F 3,406 2,924 $0.00
90685 140 133 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 174 91 $0.00
90687 75 33 $0.00
81002 56 26 $0.00
90658 33 31 $0.00