Medicaid Provider Spending

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

EDWARD W. SPARROW HOSPITAL ASSOCIATION

NPI: 1205213014 · OKEMOS, MI 48864 · Clinic/Center · NPI assigned 04/30/2015

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

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

$704K
Total Medicaid Paid
40,381
Total Claims
38,465
Beneficiaries
28
Codes Billed
2018-01
First Month
2024-04
Last Month

Provider Details

Authorized OfficialRUSSIAN, MISTY (REGIONAL MGR, PROVIDER ENROLLMENT)
Parent OrganizationSPARROW HEALTH SYSTEM
NPI Enumeration Date04/30/2015

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
2018 6,651 $159K
2019 7,924 $173K
2020 4,988 $98K
2021 3,542 $70K
2022 4,975 $74K
2023 8,983 $92K
2024 3,318 $37K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 5,697 5,397 $345K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 4,916 4,739 $218K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,388 1,381 $82K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,171 2,129 $19K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 370 369 $15K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 955 829 $15K
81025 769 755 $5K
81003 1,146 1,126 $2K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 76 76 $2K
90686 47 47 $654.17
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 64 64 $493.39
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 5,258 4,963 $0.00
4004F 1,645 1,557 $0.00
G8484 Influenza immunization was not administered, reason not given 4,323 4,086 $0.00
3077F 415 406 $0.00
G8482 Influenza immunization administered or previously received 89 85 $0.00
3078F 1,843 1,749 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 184 176 $0.00
G8938 Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible 50 49 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 654 608 $0.00
3080F 189 186 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 1,600 1,498 $0.00
3074F 1,688 1,604 $0.00
1036F 3,874 3,631 $0.00
3079F 429 423 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 121 119 $0.00
3075F 357 351 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 63 62 $0.00