Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

EDWARD W. SPARROW HOSPITAL ASSOCIATION

NPI: 1083668545 · MASON, MI 48854 · Family Medicine Physician · NPI assigned 05/20/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official RUSSIAN, MISTY controls 20+ related entities in our dataset. Read more

$2.44M
Total Medicaid Paid
168,709
Total Claims
146,884
Beneficiaries
76
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRUSSIAN, MISTY (SUPERVISOR)
Parent OrganizationSPARROW HEALTH SYSTEM
NPI Enumeration Date05/20/2006

Related Entities

Other providers sharing the same authorized official: RUSSIAN, MISTY

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 31,985 $292K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 31,154 26,215 $1.33M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,888 7,246 $497K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,985 1,877 $107K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,400 1,395 $107K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 967 966 $69K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,128 1,124 $61K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 733 733 $50K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 640 640 $50K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 457 456 $32K
99232 Subsequent hospital care, per day, moderate complexity 633 179 $24K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 211 210 $19K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,214 2,193 $15K
90472 Immunization administration, each additional vaccine (list separately) 961 957 $14K
96127 4,438 3,882 $12K
90686 809 807 $11K
99238 Hospital discharge day management, 30 minutes or less 268 251 $10K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 369 342 $10K
99222 Initial hospital care, per day, moderate complexity 57 55 $4K
90670 244 243 $4K
90832 Psychotherapy, 30 minutes with patient 86 69 $3K
90732 28 28 $3K
99496 27 27 $3K
90715 81 80 $2K
90460 Immunization administration through 18 years of age via any route, first or only component 150 150 $2K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 170 160 $2K
99490 Ccm add 20min 62 62 $2K
99215 Prolong outpt/office vis 16 16 $2K
99188 131 131 $1K
81025 169 158 $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) 985 930 $826.41
96110 Developmental screening, with scoring and documentation, per standardized instrument 66 64 $653.20
0031A 17 17 $643.45
81003 287 268 $547.71
90474 121 121 $327.00
98927 12 12 $240.66
90656 13 13 $210.00
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 14 14 $61.75
81002 37 35 $33.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 3,264 3,091 $0.00
1123F 467 427 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 5,639 4,778 $0.00
1036F 14,382 12,298 $0.00
3074F 9,230 8,252 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 3,262 2,697 $0.00
1101F 180 160 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 1,869 1,574 $0.00
3079F 2,214 2,096 $0.00
3080F 864 819 $0.00
90744 14 14 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 738 681 $0.00
3075F 1,843 1,762 $0.00
90723 24 24 $0.00
90698 80 80 $0.00
3044F 116 107 $0.00
1111F 101 84 $0.00
96161 17 13 $0.00
90647 13 13 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 2,894 2,446 $0.00
G8484 Influenza immunization was not administered, reason not given 8,464 7,272 $0.00
G8482 Influenza immunization administered or previously received 4,244 3,672 $0.00
G9900 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified 324 282 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 4,754 4,081 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 20,256 17,231 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 2,993 2,414 $0.00
4004F 8,419 6,721 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 1,676 1,502 $0.00
3077F 1,274 1,187 $0.00
3078F 9,271 8,316 $0.00
0502F 158 90 $0.00
3046F 312 285 $0.00
G8938 Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible 230 194 $0.00
90461 31 31 $0.00
96160 12 12 $0.00
90648 24 24 $0.00
3051F 12 12 $0.00
90633 16 16 $0.00