Medicaid Provider Spending

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

EDWARD W SPARROW HOSPITAL ASSOCIATION

NPI: 1124654793 · EAST LANSING, MI 48823 · Family Medicine Physician · NPI assigned 03/16/2020

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

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

$337K
Total Medicaid Paid
26,080
Total Claims
23,737
Beneficiaries
28
Codes Billed
2020-10
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRUSSIAN, MISTY (SUPERVISOR, PROVIDER ENROLLMENT)
Parent OrganizationSPARROW HEALTH SYSTEM
NPI Enumeration Date03/16/2020

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
EDWARD W. SPARROW HOSPITAL ASSOCIATION MASON MI $2.44M
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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 483 $7K
2021 3,228 $57K
2022 5,226 $83K
2023 9,590 $108K
2024 7,553 $82K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 4,130 3,761 $245K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,942 1,826 $82K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 95 95 $8K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 24 24 $2K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 12 12 $768.49
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) 177 171 $49.97
96127 15 15 $14.90
4004F 1,083 928 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 4,294 3,799 $0.00
G8484 Influenza immunization was not administered, reason not given 1,776 1,566 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 388 307 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 404 358 $0.00
3078F 1,850 1,774 $0.00
G8482 Influenza immunization administered or previously received 806 717 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 121 114 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 591 559 $0.00
3077F 258 251 $0.00
3079F 643 627 $0.00
1036F 3,569 3,133 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 787 732 $0.00
3075F 411 399 $0.00
3074F 1,922 1,848 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 476 442 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 172 150 $0.00
3080F 88 84 $0.00
G8756 No documentation of blood pressure measurement, reason not given 14 13 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 13 13 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 19 19 $0.00