Physician
Edward W. Sparrow Hospital Association
Edward W. Sparrow Hospital Association was paid $2.44M by Medicaid between Jan 2018 and Dec 2024, across 76 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 54% of everything it billed.
33Billing provider infoEDWARD W. SPARROW HOSPITAL ASSOCIATION
MASON, MI 48854
MASON, MI 48854
33aNPI1083668545assigned 05/20/2006
33bProvider typeFamily Medicine Physician
28Total paid$2.44M
24GClaims168,709
24DCodes billed76
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Michigan
Rank by total paid#45 of 826
Median peer was paid$98K
This provider vs. median25×
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 RUSSIAN, MISTY 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 | 17,144 | $333K | |
| 2019 | 20,991 | $394K | |
| 2020 | 14,071 | $262K | |
| 2021 | 21,857 | $362K | |
| 2022 | 26,151 | $393K | |
| 2023 | 36,510 | $407K | |
| 2024incomplete | 31,985 | $292K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 54% | 31,154 | 26,215 | $1.33M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 20% | 7,888 | 7,246 | $497K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.4% | 1,985 | 1,877 | $107K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.4% | 1,400 | 1,395 | $107K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.8% | 967 | 966 | $69K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.5% | 1,128 | 1,124 | $61K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.1% | 733 | 733 | $50K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 2.0% | 640 | 640 | $50K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.3% | 457 | 456 | $32K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 633 | 179 | $24K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 211 | 210 | $19K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,214 | 2,193 | $15K |
64 more codes
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 961 | $14K |
| 96127 | <1% | 4,438 | $12K | |
| 90686 | <1% | 809 | $11K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 268 | $10K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 369 | $10K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 57 | $4K |
| 90670 | <1% | 244 | $4K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 86 | $3K |
| 90732 | <1% | 28 | $3K | |
| 99496 | <1% | 27 | $3K | |
| 90715 | <1% | 81 | $2K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 150 | $2K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 170 | $2K |
| 99490 | Ccm add 20min | <1% | 62 | $2K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 16 | $2K |
| 99188 | <1% | 131 | $1K | |
| 81025 | <1% | 169 | $1K | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 985 | $826.41 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 66 | $653.20 |
| 0031A | <1% | 17 | $643.45 | |
| 81003 | <1% | 287 | $547.71 | |
| 90474 | <1% | 121 | $327.00 | |
| 98927 | <1% | 12 | $240.66 | |
| 90656 | <1% | 13 | $210.00 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 14 | $61.75 |
| 81002 | <1% | 37 | $33.00 | |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 3,264 | $0.00 |
| 1123F | 0% | 467 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 5,639 | $0.00 |
| 1036F | 0% | 14,382 | $0.00 | |
| 3074F | 0% | 9,230 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 3,262 | $0.00 |
| 1101F | 0% | 180 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 1,869 | $0.00 |
| 3079F | 0% | 2,214 | $0.00 | |
| 3080F | 0% | 864 | $0.00 | |
| 90744 | 0% | 14 | $0.00 | |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 738 | $0.00 |
| 3075F | 0% | 1,843 | $0.00 | |
| 90723 | 0% | 24 | $0.00 | |
| 90698 | 0% | 80 | $0.00 | |
| 3044F | 0% | 116 | $0.00 | |
| 1111F | 0% | 101 | $0.00 | |
| 96161 | 0% | 17 | $0.00 | |
| 90647 | 0% | 13 | $0.00 | |
| G9899 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed | 0% | 2,894 | $0.00 |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 8,464 | $0.00 |
| G8482 | Influenza immunization administered or previously received | 0% | 4,244 | $0.00 |
| G9900 | Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified | 0% | 324 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 4,754 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 20,256 | $0.00 |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 2,993 | $0.00 |
| 4004F | 0% | 8,419 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 1,676 | $0.00 |
| 3077F | 0% | 1,274 | $0.00 | |
| 3078F | 0% | 9,271 | $0.00 | |
| 0502F | 0% | 158 | $0.00 | |
| 3046F | 0% | 312 | $0.00 | |
| G8938 | Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible | 0% | 230 | $0.00 |
| 90461 | 0% | 31 | $0.00 | |
| 96160 | 0% | 12 | $0.00 | |
| 90648 | 0% | 24 | $0.00 | |
| 3051F | 0% | 12 | $0.00 | |
| 90633 | 0% | 16 | $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 officialRUSSIAN, MISTY (SUPERVISOR)
Parent organizationSPARROW HEALTH SYSTEM
| Provider | Location | Paid |
|---|---|---|
| Edward W Sparrow Hospital Association | Lansing, MI | $125.88M |
| Metropolitan Hospital | Wyoming, MI | $100.96M |
| Sparrow Ionia Hospital | Ionia, MI | $13.76M |
| Sparrow Eaton Hospital | Charlotte, MI | $13.22M |
| Sparrow Clinton Hospital | Saint Johns, MI | $8.68M |
| Edward W. Sparrow Hospital Association | Lansing, MI | $5.81M |
| Sparrow Carson Hospital | Carson City, MI | $5.48M |
| Edward W. Sparrow Hospital Association | East Lansing, MI | $5.43M |
| Sparrow Ionia Hospital | Ionia, MI | $3.49M |
| Sparrow Eaton Hospital | Charlotte, MI | $3.12M |
| Edward W. Sparrow Hospital Association | Lansing, MI | $2.77M |
| Edward W. Sparrow Hospital Association | Lansing, MI | $2.61M |
| Edward W Sparrow Hospital Association | Lansing, MI | $2.48M |
| Sparrow Community Care | Lansing, MI | $2.31M |
| Edward W Sparrow Hospital Association | Lansing, MI | $2.31M |
| Edward W Sparrow Hospital Association | Lansing, MI | $1.85M |
| Edward W. Sparrow Hospital Association | Lansing, MI | $1.83M |
| Edward W. Sparrow Hospital Association | Lansing, MI | $1.65M |
| Sparrow Ionia Hospital | Portland, MI | $1.61M |
| Sparrow Carson Hospital | Ithaca, MI | $1.54M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.