Medicaid Provider Spending

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

MERCY HEALTH PARTNERS SUB-SPECIALTY SERVICES

NPI: 1124042700 · MUSKEGON, MI 49444 · Pulmonary Disease Physician · NPI assigned 07/27/2006

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

Authorized official GUSHO, MICHAEL controls 20+ related entities in our dataset. Read more

$1.38M
Total Medicaid Paid
36,086
Total Claims
30,770
Beneficiaries
40
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGUSHO, MICHAEL (CHIEF FINANCIAL OFFICER)
Parent OrganizationMERCY HEALTH PARTNERS
NPI Enumeration Date07/27/2006

Related Entities

Other providers sharing the same authorized official: GUSHO, MICHAEL

ProviderCityStateTotal Paid
ST JOSEPH MERCY HOSPITAL YPSILANTI MI $65.22M
ST JOSEPH MERCY HOSPITAL-SMHC PONTIAC MI $51.85M
TRINITY HEALTH-MICHIGAN ST MARY MERCY HOSPITAL DIVISION LIVONIA MI $27.75M
SAINT JOSEPH MERCY LIVINGSTON HOSPITAL HOWELL MI $18.28M
MERCY PHYSICIAN NETWORK MUSKEGON MI $11.14M
ST JOSEPH MERCY CHELSEA INC CHELSEA MI $6.89M
MERCY HEALTH PARTNERS - PHYSICIAN SPECIALIST MUSKEGON MI $5.34M
MERCY SPECIALTY SERVICES MUSKEGON MI $5.27M
MERCY HEALTH PARTNERS-OBSTETRICS AND GYNECOLOGY SPECIALIST MUSKEGON MI $1.67M
MERCY HEALTH WESTSHORE CARDIOLOGY SERVICES MUSKEGON MI $1.56M
SAINT MARY'S HEALTH SERVICES GRAND RAPIDS MI $1.22M
MERCY WOMEN'S HEALTH SERVICES MUSKEGON MI $1.08M
ST JOSEPH MERCY HOSPITAL YPSILANTI MI $653K
CHELSEA COMMUNITY HOSPITAL CHELSEA MI $597K
ST JOSEPH MERCY HOSPITAL CANTON MI $474K
SJMHS ANESTHESIA SERVICES YPSILANTI MI $459K
LAKES OBGYN SPECIALIST NORTON SHORES MI $425K
CHELSEA COMMUNITY HOSPITAL CHELSEA MI $223K
JOHNSON FAMILY CENTER FOR CANCER CARE MUSKEGON MI $156K
ST MARY MERCY HOSPITAL CRNA LIVONIA MI $102K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,558 $151K
2019 4,658 $129K
2020 3,429 $153K
2021 5,089 $266K
2022 4,576 $196K
2023 6,389 $260K
2024 7,387 $224K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 3,513 744 $404K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,935 2,914 $210K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,519 4,453 $208K
99232 Subsequent hospital care, per day, moderate complexity 2,481 1,145 $91K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,909 2,869 $90K
99233 Prolong inpt eval add15 m 1,463 635 $78K
95810 Polysomnography; sleep staging with 4 or more additional parameters 1,095 1,056 $70K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,143 1,131 $50K
95806 1,174 1,151 $33K
99215 Prolong outpt/office vis 376 374 $25K
95811 312 294 $18K
94726 2,796 2,780 $17K
94060 2,538 2,523 $15K
99254 153 148 $14K
94729 2,965 2,947 $13K
99222 Initial hospital care, per day, moderate complexity 145 137 $10K
99244 Office or other outpatient consultation, moderate to high complexity 100 100 $9K
99223 Prolong inpt eval add15 m 84 80 $8K
99243 93 91 $5K
99205 Prolong outpt/office vis 48 48 $4K
94010 495 493 $2K
G9002 Coordinated care fee, maintenance rate 70 63 $1K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 12 12 $736.62
95801 14 14 $714.27
90686 16 16 $268.51
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) 55 55 $184.34
99406 25 24 $128.74
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 15 15 $105.98
3079F 569 568 $0.00
3074F 1,326 1,305 $0.00
3075F 493 493 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 144 141 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 147 143 $0.00
99024 14 14 $0.00
3008F 46 45 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 259 252 $0.00
0502F 96 67 $0.00
3077F 61 61 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 84 84 $0.00
3078F 1,303 1,285 $0.00