NPI: 1952496176 · GERMANTOWN, IL 62245 · Family Medicine Physician · NPI assigned 10/04/2006
| Authorized Official | EVARD, MARK (VP OF REVENUE CYCLE) |
| NPI Enumeration Date | 10/04/2006 |
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 | NEW BADEN | IL | $133K |
| 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 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 757 | $27K |
| 2019 | 406 | $18K |
| 2020 | 1,820 | $78K |
| 2021 | 212 | $12K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 2,092 | 1,274 | $135K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 119 | 119 | $0.00 |
| 99177 | 30 | 30 | $0.00 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 80 | 76 | $0.00 |
| 90670 | 72 | 70 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 18 | 18 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 37 | 37 | $0.00 |
| 90707 | 17 | 16 | $0.00 | |
| 90716 | 14 | 13 | $0.00 | |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 564 | 359 | $0.00 |
| 90698 | 41 | 39 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 62 | 62 | $0.00 |
| 90686 | 49 | 49 | $0.00 |