Medicaid Provider Spending

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

EDWARD W. SPARROW HOSPITAL ASSOCIATION

NPI: 1477509313 · EAST LANSING, MI 48823 · Urgent Care Clinic/Center · 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

$5.43M
Total Medicaid Paid
391,292
Total Claims
369,091
Beneficiaries
66
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
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
SPARROW CARSON HOSPITAL ITHACA MI $1.54M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 31,211 $508K
2019 42,110 $777K
2020 34,423 $529K
2021 41,269 $686K
2022 56,997 $869K
2023 97,498 $1.06M
2024 87,784 $1.00M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 52,290 49,413 $2.10M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 37,362 35,553 $2.07M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 14,517 14,456 $746K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 2,118 2,113 $163K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 3,128 3,099 $116K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 7,012 6,814 $82K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,716 2,635 $72K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 3,171 2,425 $40K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,678 1,633 $15K
81025 1,231 1,213 $7K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 1,133 1,126 $5K
81003 2,962 2,887 $5K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 392 387 $4K
93000 267 262 $2K
12001 83 82 $2K
99422 120 114 $2K
99215 Prolong outpt/office vis 16 15 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 179 179 $1K
J1885 Injection, ketorolac tromethamine, per 15 mg 500 488 $833.62
90715 28 28 $773.95
99421 63 59 $474.85
90686 38 38 $416.66
29125 12 12 $308.26
J1040 Injection, methylprednisolone acetate, 80 mg 24 24 $240.10
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 49 48 $207.58
J1030 Injection, methylprednisolone acetate, 40 mg 16 16 $162.34
87807 18 18 $151.90
J1100 Injection, dexamethasone sodium phosphate, 1 mg 142 139 $150.73
86580 37 25 $123.50
81002 25 25 $68.26
J2919 Injection, methylprednisolone sodium succinate, 5 mg 59 57 $64.48
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 15 15 $51.61
86308 13 13 $46.88
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 74 73 $0.04
G8752 Most recent systolic blood pressure < 140 mmhg 3,539 3,363 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 2,046 1,902 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 3,282 3,115 $0.00
G8484 Influenza immunization was not administered, reason not given 39,690 37,092 $0.00
G9899 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results documented and reviewed 2,330 2,182 $0.00
G8938 Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible 2,109 1,966 $0.00
3078F 23,194 22,013 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 52,719 48,777 $0.00
G9900 Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified 2,215 2,043 $0.00
3077F 5,211 5,030 $0.00
G8482 Influenza immunization administered or previously received 2,258 2,095 $0.00
4004F 18,581 17,315 $0.00
G8483 Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) 107 98 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 2,297 2,201 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 4,491 4,210 $0.00
3080F 4,271 4,134 $0.00
G8419 Bmi documented outside normal parameters, no follow-up plan documented, no reason given 11,833 10,925 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 5,435 5,071 $0.00
3079F 7,386 7,205 $0.00
G8428 Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given 1,645 1,628 $0.00
3075F 5,315 5,224 $0.00
1036F 33,351 30,952 $0.00
G9231 Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period 353 326 $0.00
1111F 13 13 $0.00
1101F 274 262 $0.00
1123F 434 407 $0.00
G8756 No documentation of blood pressure measurement, reason not given 239 211 $0.00
3074F 24,417 23,088 $0.00
S9088 Services provided in an urgent care center (list in addition to code for service) 689 681 $0.00
J7626 Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg 26 25 $0.00
3014F 36 35 $0.00
G8536 No documentation of an elder maltreatment screen, reason not given 18 18 $0.00