Physician
Mercy Health Partners Sub-Specialty Services
Mercy Health Partners Sub-Specialty Services was paid $1.38M by Medicaid between Jan 2018 and Dec 2024, across 40 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 29% of everything it billed.
33Billing provider infoMERCY HEALTH PARTNERS SUB-SPECIALTY SERVICES
MUSKEGON, MI 49444
MUSKEGON, MI 49444
33aNPI1124042700assigned 07/27/2006
33bProvider typePulmonary Disease Physician
28Total paid$1.38M
24GClaims36,086
24DCodes billed40
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in Michigan
Rank by total paid#12 of 63
Median peer was paid$118K
This provider vs. median12×
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 GUSHO, MICHAEL 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 | 4,558 | $151K | |
| 2019 | 4,658 | $129K | |
| 2020 | 3,429 | $153K | |
| 2021 | 5,089 | $266K | |
| 2022 | 4,576 | $196K | |
| 2023 | 6,389 | $260K | |
| 2024incomplete | 7,387 | $224K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 29% | 3,513 | 744 | $404K |
| 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 | 15% | 2,935 | 2,914 | $210K |
| 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 | 15% | 4,519 | 4,453 | $208K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 6.6% | 2,481 | 1,145 | $91K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.5% | 2,909 | 2,869 | $90K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 5.7% | 1,463 | 635 | $78K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | 5.1% | 1,095 | 1,056 | $70K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 3.6% | 1,143 | 1,131 | $50K |
| 95806 | 2.4% | 1,174 | 1,151 | $33K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.8% | 376 | 374 | $25K |
| 95811 | 1.3% | 312 | 294 | $18K | |
| 94726 | 1.3% | 2,796 | 2,780 | $17K |
28 more codes
| 94060 | 1.1% | 2,538 | $15K | |
| 99254 | 1.0% | 153 | $14K | |
| 94729 | <1% | 2,965 | $13K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 145 | $10K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 100 | $9K |
| 99223 | Prolong inpt eval add15 m | <1% | 84 | $8K |
| 99243 | <1% | 93 | $5K | |
| 99205 | Prolong outpt/office vis | <1% | 48 | $4K |
| 94010 | <1% | 495 | $2K | |
| G9002 | Coordinated care fee, maintenance rate | <1% | 70 | $1K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $736.62 |
| 95801 | <1% | 14 | $714.27 | |
| 90686 | <1% | 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) | <1% | 55 | $184.34 |
| 99406 | <1% | 25 | $128.74 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 15 | $105.98 |
| 3079F | 0% | 569 | $0.00 | |
| 3074F | 0% | 1,326 | $0.00 | |
| 3075F | 0% | 493 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 144 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 147 | $0.00 |
| 99024 | 0% | 14 | $0.00 | |
| 3008F | 0% | 46 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 259 | $0.00 |
| 0502F | 0% | 96 | $0.00 | |
| 3077F | 0% | 61 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 84 | $0.00 |
| 3078F | 0% | 1,303 | $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 officialGUSHO, MICHAEL (CHIEF FINANCIAL OFFICER)
Parent organizationMERCY HEALTH PARTNERS
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.