Medicaid Provider Spending

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

SPARROW IONIA HOSPITAL

NPI: 1295801108 · PORTLAND, MI 48875 · Family Medicine Physician · NPI assigned 11/24/2006

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

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

$1.61M
Total Medicaid Paid
77,095
Total Claims
68,514
Beneficiaries
60
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRUSSIAN, MISTY (SUPERVISOR. PROVIDER ENROLLMENT)
Parent OrganizationSPARROW HEALTH SYSTEM
NPI Enumeration Date11/24/2006

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 CARSON HOSPITAL ITHACA MI $1.54M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 10,432 $201K
2019 8,169 $210K
2020 6,526 $189K
2021 7,758 $217K
2022 10,755 $266K
2023 16,982 $265K
2024 16,473 $266K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1015 Clinic visit/encounter, all-inclusive 23,908 19,831 $1.10M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 11,022 9,720 $187K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,313 6,695 $178K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,015 1,002 $39K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 878 874 $28K
90460 Immunization administration through 18 years of age via any route, first or only component 2,266 2,242 $25K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 951 924 $23K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 167 167 $7K
90677 126 126 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 894 880 $4K
90686 1,099 1,094 $4K
90670 468 465 $3K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 264 216 $2K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 327 310 $2K
91320 13 13 $835.94
96127 407 384 $760.55
90651 12 12 $688.02
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 24 24 $677.69
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 12 12 $650.72
0124A 38 35 $638.01
99215 Prolong outpt/office vis 16 14 $523.95
90472 Immunization administration, each additional vaccine (list separately) 116 111 $441.00
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 25 22 $355.04
87807 53 50 $308.30
90656 60 60 $207.13
99406 28 27 $159.29
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 14 13 $120.84
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 15 15 $49.92
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) 136 126 $13.40
3078F 3,302 3,043 $0.00
G8482 Influenza immunization administered or previously received 1,102 952 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 769 696 $0.00
90461 1,122 1,109 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 219 200 $0.00
90648 310 308 $0.00
90685 71 71 $0.00
4004F 1,512 1,300 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 3,500 3,097 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 14 12 $0.00
3077F 132 124 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 134 120 $0.00
90681 50 50 $0.00
G8484 Influenza immunization was not administered, reason not given 2,686 2,340 $0.00
90633 13 12 $0.00
3046F 14 13 $0.00
90698 144 143 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 616 577 $0.00
3075F 669 634 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 248 236 $0.00
1036F 2,498 2,221 $0.00
90680 71 69 $0.00
3074F 3,792 3,474 $0.00
3079F 1,215 1,131 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 833 746 $0.00
90723 130 128 $0.00
3080F 73 69 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 152 138 $0.00
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 12 12 $0.00
90744 12 12 $0.00
1101F 13 13 $0.00