Medicaid Provider Spending

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

EDWARD W. SPARROW HOSPITAL ASSOCIATION

NPI: 1427004183 · LANSING, MI 48912 · Family Medicine Physician · NPI assigned 05/25/2006

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

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

$616K
Total Medicaid Paid
37,413
Total Claims
35,254
Beneficiaries
43
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialRUSSIAN, MISTY (SUPERVISOR, PROVIDER ENROLLMENT)
Parent OrganizationSPARROW HEALTH SYSTEM
NPI Enumeration Date05/25/2006

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 IONIA HOSPITAL PORTLAND MI $1.61M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 5,315 $128K
2019 4,229 $113K
2020 2,181 $54K
2021 3,281 $65K
2022 4,184 $69K
2023 7,587 $85K
2024 10,636 $102K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,677 5,363 $241K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 3,598 3,432 $222K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 576 576 $45K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 695 676 $41K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 274 274 $18K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 162 161 $11K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 79 79 $7K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 90 90 $7K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 884 876 $6K
90472 Immunization administration, each additional vaccine (list separately) 358 355 $5K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 45 45 $3K
90686 271 270 $3K
90460 Immunization administration through 18 years of age via any route, first or only component 177 176 $3K
99421 116 110 $1K
90632 14 14 $723.24
90670 54 53 $635.77
96127 174 169 $602.08
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 13 13 $289.14
90688 14 14 $249.76
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 14 14 $191.66
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) 675 629 $166.44
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 4,649 4,306 $0.00
G8484 Influenza immunization was not administered, reason not given 2,395 2,222 $0.00
4004F 922 825 $0.00
G8482 Influenza immunization administered or previously received 1,089 994 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 723 675 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 1,139 1,039 $0.00
3078F 2,625 2,515 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 258 243 $0.00
3077F 63 61 $0.00
90461 14 14 $0.00
90685 12 12 $0.00
3046F 12 12 $0.00
1036F 4,088 3,755 $0.00
3075F 285 279 $0.00
3079F 759 732 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 522 492 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 777 722 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 44 39 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 98 93 $0.00
3080F 13 13 $0.00
3074F 2,954 2,810 $0.00
3044F 12 12 $0.00