Clinic
Edward W. Sparrow Hospital Association
Edward W. Sparrow Hospital Association was paid $704K by Medicaid between Jan 2018 and Apr 2024, across 28 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 49% of everything it billed.
33Billing provider infoEDWARD W. SPARROW HOSPITAL ASSOCIATION
OKEMOS, MI 48864
OKEMOS, MI 48864
33aNPI1205213014assigned 04/30/2015
33bProvider typeClinic/Center
28Total paid$704K
24GClaims40,381
24DCodes billed28
24AFirst – last monthJan 2018 – Apr 2024
Compared with peers
Next to other Clinic/Center providers in Michigan
Rank by total paid#23 of 121
Median peer was paid$71K
This provider vs. median10.0×
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 RUSSIAN, MISTY 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 | 6,651 | $159K | |
| 2019 | 7,924 | $173K | |
| 2020 | 4,988 | $98K | |
| 2021 | 3,542 | $70K | |
| 2022 | 4,975 | $74K | |
| 2023 | 8,983 | $92K | |
| 2024incomplete | 3,318 | $37K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 49% | 5,697 | 5,397 | $345K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 31% | 4,916 | 4,739 | $218K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 12% | 1,388 | 1,381 | $82K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.7% | 2,171 | 2,129 | $19K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 2.2% | 370 | 369 | $15K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.1% | 955 | 829 | $15K |
| 81025 | <1% | 769 | 755 | $5K | |
| 81003 | <1% | 1,146 | 1,126 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 76 | 76 | $2K |
| 90686 | <1% | 47 | 47 | $654.17 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 64 | 64 | $493.39 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 5,258 | 4,963 | $0.00 |
16 more codes
| 4004F | 0% | 1,645 | $0.00 | |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 4,323 | $0.00 |
| 3077F | 0% | 415 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 89 | $0.00 |
| 3078F | 0% | 1,843 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 184 | $0.00 |
| G8938 | Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible | 0% | 50 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 654 | $0.00 |
| 3080F | 0% | 189 | $0.00 | |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 1,600 | $0.00 |
| 3074F | 0% | 1,688 | $0.00 | |
| 1036F | 0% | 3,874 | $0.00 | |
| 3079F | 0% | 429 | $0.00 | |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 121 | $0.00 |
| 3075F | 0% | 357 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 63 | $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 officialRUSSIAN, MISTY (REGIONAL MGR, PROVIDER ENROLLMENT)
Parent organizationSPARROW HEALTH SYSTEM
| Provider | Location | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.