Grand River Gastroenterology PC
Grand River Gastroenterology PC was paid $611K by Medicaid between Jan 2018 and Apr 2024, across 19 billing codes. Its largest line is 45385, Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) — 15% of everything it billed.
33Billing provider infoGRAND RIVER GASTROENTEROLOGY PC
GRAND RAPIDS, MI 49503
GRAND RAPIDS, MI 49503
33aNPI1164470472assigned 05/05/2006
33bProvider typeSpecialist
28Total paid$611K
24GClaims9,457
24DCodes billed19
24AFirst – last monthJan 2018 – Apr 2024
Compared with peers
Next to other Specialist providers in Michigan
Rank by total paid#39 of 181
Median peer was paid$94K
This provider vs. median6.5×
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 | 1,852 | $108K | |
| 2019 | 1,491 | $95K | |
| 2020 | 1,174 | $71K | |
| 2021 | 1,944 | $138K | |
| 2022 | 1,465 | $94K | |
| 2023 | 1,243 | $87K | |
| 2024incomplete | 288 | $19K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 15% | 693 | 690 | $91K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 12% | 1,950 | 827 | $75K |
| 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 | 12% | 915 | 893 | $75K |
| 99223 | Prolong inpt eval add15 m | 12% | 711 | 683 | $72K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 10% | 1,056 | 1,046 | $62K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 9.1% | 659 | 656 | $56K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 6.5% | 649 | 646 | $40K |
| 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% | 1,001 | 985 | $39K |
| 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 | 5.6% | 622 | 596 | $34K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 4.7% | 294 | 292 | $29K |
| 43235 | 4.3% | 475 | 472 | $27K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.6% | 182 | 144 | $10K |
7 more codes
| 43450 | <1% | 54 | $1K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 28 | $826.91 |
| 00811 | <1% | 17 | $389.60 | |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 78 | $337.09 |
| 00731 | <1% | 12 | $324.88 | |
| 99153 | Mod sedat endo service >5yrs | <1% | 28 | $4.12 |
| 99152 | 0% | 33 | $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 officialRUMISEK, DENA (BILLING)