Physician
Lake Michigan Emergency Specialists, PLLC
Lake Michigan Emergency Specialists, PLLC was paid $16.96M by Medicaid between Jan 2018 and Dec 2024, across 40 billing codes. Its largest line is 99284, emergency room visit (serious) — 39% of everything it billed.
33Billing provider infoLAKE MICHIGAN EMERGENCY SPECIALISTS, PLLC
MUSKEGON, MI 49442
MUSKEGON, MI 49442
33aNPI1124574520assigned 08/27/2016
33bProvider typeEmergency Medicine Physician
28Total paid$16.96M
24GClaims317,539
24DCodes billed40
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Emergency Medicine Physician providers in Michigan
Rank by total paid#4 of 248
Median peer was paid$57K
This provider vs. median300×
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.
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 | 56,957 | $2.60M | |
| 2019 | 56,765 | $2.52M | |
| 2020 | 44,245 | $2.29M | |
| 2021 | 42,654 | $2.38M | |
| 2022 | 43,560 | $2.50M | |
| 2023 | 41,029 | $2.47M | |
| 2024incomplete | 32,329 | $2.20M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 39% | 114,260 | 103,530 | $6.62M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 30% | 92,739 | 85,933 | $5.11M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 21% | 53,460 | 47,854 | $3.49M |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | 6.1% | 8,759 | 8,433 | $1.04M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 2.0% | 6,069 | 5,915 | $331K |
| 10061 | <1% | 1,091 | 1,061 | $94K | |
| 12001 | <1% | 2,949 | 2,914 | $74K | |
| 12011 | <1% | 1,514 | 1,505 | $49K | |
| 12002 | <1% | 1,360 | 1,348 | $45K | |
| 93042 | <1% | 12,820 | 11,943 | $41K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 574 | 562 | $27K |
| 31500 | <1% | 163 | 161 | $12K |
28 more codes
| 99292 | <1% | 154 | $11K | |
| 10060 | <1% | 252 | $11K | |
| 64400 | <1% | 178 | $7K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 195 | $3K |
| 99152 | <1% | 195 | $1K | |
| 93308 | <1% | 95 | $1K | |
| 36556 | <1% | 14 | $538.29 | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 13 | $205.50 |
| 99053 | <1% | 1,251 | $20.02 | |
| G8708 | Patient not prescribed antibiotic | <1% | 7,055 | $0.01 |
| G9530 | Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider | 0% | 2,533 | $0.00 |
| G9529 | Patient with minor blunt head trauma had an appropriate indication(s) for a head ct | 0% | 2,400 | $0.00 |
| G8711 | Prescribed antibiotic on or within 3 days after the episode date | 0% | 1,119 | $0.00 |
| G9350 | Ct scan of the paranasal sinuses not ordered at the time of diagnosis or received within 28 days after date of diagnosis | 0% | 54 | $0.00 |
| 4130F | 0% | 31 | $0.00 | |
| G9532 | Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma | 0% | 224 | $0.00 |
| G9594 | Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider | 0% | 64 | $0.00 |
| 4132F | 0% | 31 | $0.00 | |
| G9597 | Pediatric patient with minor blunt head trauma not classified as low risk according to the pecarn prediction rules | 0% | 39 | $0.00 |
| G9712 | Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis | 0% | 14 | $0.00 |
| G8806 | Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented | 0% | 2,042 | $0.00 |
| 3210F | 0% | 1,159 | $0.00 | |
| G8712 | Antibiotic not prescribed or dispensed | 0% | 1,658 | $0.00 |
| 4124F | 0% | 659 | $0.00 | |
| G8709 | Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne) | 0% | 145 | $0.00 |
| G9596 | Pediatric patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma | 0% | 135 | $0.00 |
| G9533 | Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct | 0% | 54 | $0.00 |
| 4120F | 0% | 18 | $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 officialWHITAKER, MARC (BOARD MEMBER)
| Provider | Location | Paid |
|---|---|---|
| Lake Michigan Observation Services PLLC | Muskegon, MI | $213K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.