Providers
SUSIE MARIE AVERY, APRN
NPI 1043709660, individual, Galesburg, IL, Nurse Practitioner, Family
5
Evidence tier
informational
- Medicaid dollars per patient on code 99202 ($406 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 10045, $1.4M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SUSIE MARIE AVERY, APRN |
| Type | Individual |
| Status | Active |
| NPI issued | May 9, 2018, last updated May 9, 2018 |
| Practice location | 1887 SUNSET DR, Galesburg, IL 61401-8531, 309-371-9300 |
| Specialties | Nurse Practitioner, Family (363LF0000X, license 209.017133 IL) Nurse Practitioner, Family (363LF0000X, primary, license AP10890 AZ) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $1.5M | 76% | $406 | $45 (top 5% from $138) | 100th percentile | |
| 99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $256K | 13% | $324 | $128 (top 5% from $249) | 98th percentile | |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $43K | 2% | $101 | $30 (top 5% from $134) | 91st percentile | |
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | $36K | 2% | $77 | $79 (top 5% from $359) | 49th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $30K | 2% | $484 | $44 (top 5% from $110) | too few months to rank | |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $29K | 2% | $64 | $21 (top 5% from $84) | 91st percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $29K | 1% | $353 | $88 (top 5% from $210) | too few months to rank | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $24K | 1% | $556 | $67 (top 5% from $121) | too few months to rank |
In this area
5 providers in Knox County, IL carry an indicator in the public record, with $0 at stake between them. The most common is part of a provider network, on 5 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | BEACON OF HOPE HOSPICE OF ILLINOIS Galesburg, IL, ranked 2280 | $0 |
|
| 3 | ALLURE OF GALESBURG, LLC Galesburg, IL, ranked 3056 | $0 |
|
| 3 | ALLURE OF LAKE STOREY, LLC Galesburg, IL, ranked 5177 | $0 |
|
| 3 | MARIGOLD HCO LLC Galesburg, IL, ranked 5582 | $0 |
|
| 3 | ALLURE OF KNOX COUNTY, LLC Galesburg, IL, ranked 7151 | $0 |
|
Recent enforcement in IL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
United States Attorney Andrew S. Boutros Announces Charges Against Two Chicago-Area Defendants as Part of Department of Justice’s National Healthcare Fraud Takedown
Two Chicago-area defendants were charged, one for selling Medicare beneficiary information and providing fake AI-generated consent recordings so laboratories could bill Medicare for over-the-counter Covid-19 test kits that were never requested or provided, and the other for directing the creation of fake medical records and billing Illinois Medicaid for behavioral health counseling and therapy services that were never provided, including for deceased beneficiaries.
DOJConvictedJun 18, 2026
Suburban Chicago Chiropractor Convicted of Healthcare Fraud
A chiropractor submitted fraudulent claims to Blue Cross Blue Shield of Illinois for health care services that were not actually provided and submitted false patient medical records when the insurer attempted to audit the claims.
DOJSentencedJun 10, 2026
Jacksonville Chiropractor Sentenced to a Year in Prison for Healthcare Fraud and Related Offenses
Rondeau submitted more than 2,000 fraudulent claims to health insurance companies and convinced clients to sign false documents after learning he was under investigation.
DOJCivil settlementMay 8, 2026
Three Affiliated Skilled Nursing Facilities to Pay $300,000 to Resolve False Claims Act Allegations Related to Medically Unnecessary Rehabilitation Services
Three affiliated skilled nursing facilities billed Medicare between Jan. 1, 2014, and Sept. 30, 2019, for physical therapy, occupational therapy, and speech pathology services provided to patients for longer than medically necessary and without regard for patients' individual medical needs, resulting in claims based on inflated RUG levels.
DOJIndictedFeb 12, 2026
Two Foreign Nationals Indicted in Chicago as Part of $10 Million Health Care Fraud Scheme
The indictment alleges the defendants used nominee-owned laboratories and durable medical equipment providers to submit fraudulent claims to Medicare and private health care benefit programs for items and services that were not provided, and laundered and transferred proceeds to Pakistan.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.