Physician
Southern Illinois Healthcare Foundation, INC
Southern Illinois Healthcare Foundation, INC was paid $12.04M by Medicaid between Jan 2018 and Dec 2024, across 67 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 100% of everything it billed.
33Billing provider infoSOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC
EAST ST LOUIS, IL 62201
EAST ST LOUIS, IL 62201
33aNPI1831125038assigned 06/23/2006
33bProvider typeFamily Medicine Physician
28Total paid$12.04M
24GClaims218,848
24DCodes billed67
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Illinois
Rank by total paid#4 of 2,947
Median peer was paid$43K
This provider vs. median283×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MCCULLEY, LARRY controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 18,905 | $986K | |
| 2019 | 49,910 | $1.64M | |
| 2020 | 37,255 | $2.33M | |
| 2021 | 28,810 | $1.85M | |
| 2022 | 22,486 | $1.61M | |
| 2023 | 26,224 | $1.76M | |
| 2024incomplete | 35,258 | $1.87M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 100% | 95,743 | 74,053 | $12.03M |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,302 | 1,842 | $4K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 108 | 101 | $966.00 |
| 90688 | <1% | 198 | 183 | $786.48 | |
| S5190 | Wellness assessment, performed by non-physician | <1% | 1,503 | 1,393 | $78.48 |
| 90715 | <1% | 590 | 499 | $66.33 | |
| 90686 | <1% | 3,038 | 2,471 | $58.59 | |
| 81025 | <1% | 1,886 | 1,345 | $23.23 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,832 | 1,407 | $18.90 |
| 90656 | <1% | 384 | 353 | $16.71 | |
| 96127 | <1% | 2,142 | 1,903 | $11.00 | |
| 90687 | <1% | 183 | 89 | $9.40 |
55 more codes
| 81003 | <1% | 1,942 | $8.72 | |
| 90651 | <1% | 763 | $6.40 | |
| 99173 | 0% | 2,832 | $0.00 | |
| 90670 | 0% | 1,150 | $0.00 | |
| 90633 | 0% | 539 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 90 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 1,857 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 2,067 | $0.00 |
| 3078F | 0% | 2,101 | $0.00 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 1,511 | $0.00 |
| 90734 | 0% | 471 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 1,163 | $0.00 |
| 3725F | 0% | 2,252 | $0.00 | |
| 90710 | 0% | 251 | $0.00 | |
| 3077F | 0% | 690 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 22,350 | $0.00 |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 626 | $0.00 |
| 99201 | 0% | 46 | $0.00 | |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 401 | $0.00 |
| 1160F | 0% | 1,086 | $0.00 | |
| 0502F | 0% | 40 | $0.00 | |
| 90707 | 0% | 14 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 61 | $0.00 |
| 90681 | 0% | 42 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 13 | $0.00 |
| 90672 | 0% | 34 | $0.00 | |
| 3075F | 0% | 544 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 7,502 | $0.00 |
| 99213 | Doctor's office visit, returning patient (routine) | 0% | 38,072 | $0.00 |
| 36416 | 0% | 293 | $0.00 | |
| 87428 | 0% | 118 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 0% | 769 | $0.00 |
| 90677 | 0% | 212 | $0.00 | |
| 90698 | 0% | 451 | $0.00 | |
| 82962 | 0% | 342 | $0.00 | |
| 3080F | 0% | 489 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 2,593 | $0.00 |
| Q0111 | Wet mounts, including preparations of vaginal, cervical or skin specimens | 0% | 255 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 318 | $0.00 |
| 90744 | 0% | 190 | $0.00 | |
| 3079F | 0% | 1,237 | $0.00 | |
| 90696 | 0% | 36 | $0.00 | |
| 1036F | 0% | 2,249 | $0.00 | |
| 3074F | 0% | 2,616 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 1,189 | $0.00 |
| G0467 | Community health center visit, returning patient | 0% | 192 | $0.00 |
| 3008F | 0% | 4,467 | $0.00 | |
| 90697 | 0% | 133 | $0.00 | |
| 90620 | 0% | 187 | $0.00 | |
| 90792 | Psychiatric diagnostic evaluation with medical services | 0% | 17 | $0.00 |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 0% | 12 | $0.00 |
| 1126F | 0% | 12 | $0.00 | |
| 3044F | 0% | 20 | $0.00 | |
| 85018 | 0% | 19 | $0.00 | |
| 1125F | 0% | 13 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMCCULLEY, LARRY (PRESIDENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.