Medicaid Provider Spending

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

SOUND INPATIENT PHYSICIANS-MICHIGAN, PLLC

NPI: 1093967861 · KALAMAZOO, MI 49048 · Family Medicine Physician · NPI assigned 10/10/2008

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

Authorized official FALL, LAURA controls 20+ related entities in our dataset. Read more

$12.40M
Total Medicaid Paid
215,767
Total Claims
135,833
Beneficiaries
30
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialFALL, LAURA (MANAGER)
NPI Enumeration Date10/10/2008

Related Entities

Other providers sharing the same authorized official: FALL, LAURA

ProviderCityStateTotal Paid
INPATIENT SPECIALISTS OF CALIFORNIA, PC SAN BERNARDINO CA $32.85M
SOUND PHYSICIANS EMERGENCY MEDICINE OF SOUTHERN CALIFORNIA, P.C. BAKERSFIELD CA $23.48M
T M CARR MD PC MEMPHIS TN $19.29M
SOUTH SOUND INPATIENT PHYSICIANS PLLC ARLINGTON WA $17.61M
HOSPITALIST MEDICINE PHYSICIANS OF CALIFORNIA, INC SAN JOSE CA $16.34M
HOSPITALIST MEDICINE PHYSICIANS OF TEXAS, PLLC HUMBLE TX $16.31M
COGENT HEALTHCARE OF ARIZONA PC BRENTWOOD TN $15.26M
SOUND PHYSICIANS EMERGENCY MEDICINE OF SOUTH CAROLINA LLC AIKEN SC $14.15M
HOSPITALIST MEDICINE PHYSICIANS OF OHIO, PROFESSIONAL CORPORATION MIDDLETOWN OH $9.72M
HOSPITALIST MEDICINE PHYSICIANS OF MARYLAND-FREDERICK PC FREDERICK MD $6.02M
RABESSLER MD PC LAS VEGAS NV $5.09M
SOUND PHYSICIANS OF ILLINOIS, LLC CHICAGO IL $4.98M
HOSPITALIST MEDICINE PHYSICIANS OF TEXAS - HOUSTON, PLLC BRENTWOOD TN $4.68M
COGENT HEALTHCARE OF GEORGIA PC MACON GA $4.65M
COGENT HEALTHCARE OF KENTUCKY, PSC LOUISVILLE KY $4.39M
HOSPITALIST MEDICINE PHYSICIANS OF NEW YORK, PLLC BRONX NY $4.25M
HOSPITALIST MEDICINE PHYSICIANS OF WEST VIRGINIA, PLLC WHEELING WV $4.10M
HOSPITALIST MEDICINE PHYSICIANS OF NEW MEXICO - CLOVIS, LLC HOBBS NM $4.09M
SOUND PHYSICIANS EMERGENCY MEDICINE OF KANSAS, LLC TOPEKA KS $3.37M
COGENT HEALTHCARE OF NORTH CAROLINA, PC HIGH POINT NC $3.34M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 17,537 $945K
2019 27,440 $1.53M
2020 34,959 $1.90M
2021 39,696 $2.21M
2022 37,056 $2.04M
2023 31,954 $1.98M
2024 27,125 $1.80M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99233 Prolong inpt eval add15 m 56,579 21,772 $3.23M
99223 Prolong inpt eval add15 m 24,054 22,787 $2.43M
99232 Subsequent hospital care, per day, moderate complexity 51,925 18,437 $2.04M
99239 Hospital discharge day management, more than 30 minutes 27,289 25,963 $1.58M
99220 10,047 9,741 $939K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 5,510 3,076 $651K
99222 Initial hospital care, per day, moderate complexity 5,105 4,937 $353K
99217 7,508 7,328 $266K
99219 2,643 2,565 $182K
99309 Subsequent nursing facility care, per day, low to moderate complexity 4,296 3,119 $180K
99238 Hospital discharge day management, 30 minutes or less 2,747 2,686 $108K
99310 Prolong nursin fac eval 15m 1,841 1,424 $90K
99497 1,757 1,593 $63K
99231 Subsequent hospital care, per day, straightforward or low complexity 2,696 1,287 $59K
99226 3,493 2,671 $48K
99308 Subsequent nursing facility care, per day, straightforward 1,228 1,007 $39K
99306 Prolong nursin fac eval 15m 635 612 $36K
99356 1,362 1,094 $29K
99225 2,976 2,066 $28K
99292 421 189 $26K
99236 Prolong inpt eval add15 m 113 113 $13K
99221 132 129 $6K
99406 730 661 $5K
G0317 Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99306, 99310 for nursing facility evaluation and management services). (do not report g0317 on the same date of service as other prolonged services for evaluation and management 99358, 99359, 99418). (do not report g0317 for any time unit less than 15 minutes) 430 329 $3K
99316 51 51 $3K
G0182 Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other studies, communication (including telephone calls) with other health care professionals involved in the patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month, 30 minutes or more 36 35 $713.56
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 18 16 $513.54
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 57 57 $491.05
G0136 Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months 59 59 $68.14
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 29 29 $0.00