ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE

NPI: 1821486085 · NEW BADEN, IL 62265 · Clinic/Center · NPI assigned 12/22/2014

$133K

Total Medicaid Paid

4,132

Total Claims

2,218

Beneficiaries

Codes Billed

2018-01

First Month

2020-12

Last Month

Provider Details

Authorized Official	EVARD, MARK (VP OF REVENUE CYCLE)
NPI Enumeration Date	12/22/2014

Other providers sharing the same authorized official: EVARD, MARK

Provider	City	State	Total Paid
ST MARYS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS	DECATUR	IL	$7.04M
ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F	SPRINGFIELD	IL	$1.70M
ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F	SPRINGFIELD	IL	$1.33M
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER	O FALLON	IL	$637K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	GERMANTOWN	IL	$135K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	CARLYLE	IL	$39K
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER	BELLEVILLE	IL	$38K
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE	TRENTON	IL	$15K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	2,035	1,166	$133K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	269	74	$0.00
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	375	151	$0.00
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	806	539	$0.00
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	647	288	$0.00