Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Spectrum Health Hospitals

Spectrum Health Hospitals was paid $25.15M by Medicaid between Jan 2018 and Dec 2024, across 131 billing codes. Its largest line is 59409, Vaginal delivery only (with or without episiotomy and/or forceps) — 13% of everything it billed.

33Billing provider infoSPECTRUM HEALTH HOSPITALS
GRAND RAPIDS, MI 49503
33aNPI1558407189assigned 01/30/2007
33bProvider typeInternal Medicine Physician
28Total paid$25.15M
24GClaims505,122
24DCodes billed131
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Internal Medicine Physician providers in Michigan

Rank by total paid#3 of 816
Median peer was paid$70K
This provider vs. median357×

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.

Box 24A · Dates of service

Paid by month

$0$200K$400K2018201920202021202220232024
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
YearClaimsPaid
201881,760$3.72M
201978,900$3.49M
202070,482$3.24M
202177,683$3.75M
202279,348$3.87M
202363,774$3.78M
2024incomplete53,175$3.30M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 13% 4,221 4,160 $3.18M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 12% 81,593 74,606 $3.03M
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 12% 55,971 51,820 $2.92M
59514 5.8% 1,749 1,724 $1.46M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 4.4% 15,026 11,461 $1.11M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 4.0% 17,038 3,438 $1.00M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3.8% 16,587 16,335 $945K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3.6% 19,575 17,725 $894K
99244 Office or other outpatient consultation, moderate to high complexity 3.4% 9,171 9,102 $851K
59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care 2.6% 327 319 $644K
99460 2.4% 11,716 11,529 $614K
99238 Hospital discharge day management, 30 minutes or less 2.3% 14,201 13,835 $577K
119 more codes
99204 Doctor's office visit, new patient (more involved) 2.1% 8,217 $537K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2.1% 9,172 $522K
99232 Hospital visit by a doctor, follow-up day 1.7% 10,754 $429K
99203 Doctor's office visit, new patient (routine) 1.7% 9,563 $418K
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 1.6% 11,743 $412K
59426 1.5% 569 $368K
59425 1.2% 862 $312K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.2% 7,594 $310K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 1.2% 4,800 $301K
59025 Fetal non-stress test 1.1% 16,916 $288K
59430 <1% 1,560 $233K
99243 <1% 3,924 $219K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 3,467 $217K
99245 <1% 1,945 $201K
99223 Prolong inpt eval add15 m <1% 1,885 $200K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 2,545 $178K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies <1% 160 $169K
99239 Hospital discharge day management, more than 30 minutes <1% 2,675 $161K
99462 <1% 6,932 $158K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 6,587 $157K
99221 <1% 3,032 $148K
54150 <1% 2,627 $145K
99222 Initial hospital care, per day, moderate complexity <1% 1,746 $123K
93320 <1% 11,920 $120K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 7,460 $120K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 25,347 $117K
99253 <1% 1,855 $113K
99205 Prolong outpt/office vis <1% 1,174 $112K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 858 $93K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 3,224 $86K
99242 <1% 2,007 $78K
96450 <1% 1,427 $59K
99381 <1% 1,021 $52K
99254 <1% 575 $50K
96040 <1% 1,376 $49K
97597 <1% 3,341 $49K
93304 <1% 2,383 $48K
99188 <1% 7,730 $45K
58300 <1% 1,490 $43K
H1003 Prenatal care, at-risk enhanced service; education <1% 846 $40K
99402 <1% 503 $35K
99252 <1% 861 $35K
99418 Prolong nursin fac eval 15m <1% 791 $34K
11981 <1% 863 $32K
92587 <1% 2,686 $28K
99417 Prolong home eval add 15m <1% 877 $28K
93325 <1% 15,183 $27K
99463 <1% 422 $26K
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) <1% 670 $19K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 7,935 $18K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 5,278 $17K
36415 Collection of venous blood by venipuncture <1% 3,686 $16K
92585 <1% 733 $13K
93321 <1% 3,072 $12K
93227 <1% 931 $12K
99495 <1% 156 $10K
99383 <1% 100 $6K
93308 <1% 418 $6K
0081A <1% 173 $6K
93244 <1% 394 $5K
D0190 <1% 403 $5K
92652 <1% 165 $5K
93248 <1% 278 $4K
58301 <1% 109 $4K
99255 <1% 27 $3K
81025 <1% 587 $3K
93294 <1% 183 $3K
99382 <1% 39 $2K
99385 <1% 26 $2K
93356 <1% 273 $2K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory <1% 152 $2K
94621 <1% 40 $2K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 42 $1K
41010 <1% 18 $921.15
99234 <1% 13 $903.62
99384 <1% 12 $829.38
80061 Lipid panel <1% 65 $820.24
38222 <1% 14 $766.51
99218 <1% 12 $630.10
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination <1% 37 $560.43
58100 <1% 14 $540.44
92650 <1% 74 $515.36
96380 <1% 93 $509.12
99442 <1% 13 $508.37
11982 <1% 13 $498.87
0082A <1% 16 $479.76
87428 <1% 81 $450.90
92567 <1% 55 $393.68
99201 <1% 26 $362.94
99406 <1% 63 $350.34
93000 <1% 31 $344.19
69210 <1% 23 $297.92
92579 <1% 13 $285.45
80305 <1% 125 $233.14
92588 <1% 12 $229.54
0298T <1% 214 $150.66
11055 <1% 16 $139.86
99177 <1% 561 $70.65
93018 <1% 12 $66.73
92551 <1% 31 $65.40
96127 <1% 6,338 $63.51
96160 <1% 484 $56.39
99459 <1% 58 $48.37
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit <1% 66 $38.41
96161 <1% 6,344 $12.44
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) <1% 107 $5.74
0502F 0% 851 $0.00
99173 0% 139 $0.00
3046F 0% 14 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 0% 90 $0.00
4040F 0% 27 $0.00
G8482 Influenza immunization administered or previously received 0% 52 $0.00
4004F 0% 26 $0.00
G8399 Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed 0% 13 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 0% 105 $0.00
G8484 Influenza immunization was not administered, reason not given 0% 43 $0.00
3017F 0% 64 $0.00
1101F 0% 26 $0.00
1036F 0% 78 $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 officialLACEY, ELISABETH (MANAGER)
Parent organizationSPECTRUM HEALTH HOSPITALS