Medicaid Provider Spending

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

MERCY HEALTH PARTNERS - PHYSICIAN SPECIALIST

NPI: 1922248772 · MUSKEGON, MI 49442 · Cardiovascular Disease Physician · NPI assigned 03/05/2009

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

Authorized official GUSHO, MICHAEL controls 20+ related entities in our dataset. Read more

$5.34M
Total Medicaid Paid
95,175
Total Claims
81,190
Beneficiaries
78
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGUSHO, MICHAEL (CHIEF FINANCIAL OFFICER)
Parent OrganizationMERCY HEALTH PARTNERS
NPI Enumeration Date03/05/2009

Related Entities

Other providers sharing the same authorized official: GUSHO, MICHAEL

ProviderCityStateTotal Paid
ST JOSEPH MERCY HOSPITAL YPSILANTI MI $65.22M
ST JOSEPH MERCY HOSPITAL-SMHC PONTIAC MI $51.85M
TRINITY HEALTH-MICHIGAN ST MARY MERCY HOSPITAL DIVISION LIVONIA MI $27.75M
SAINT JOSEPH MERCY LIVINGSTON HOSPITAL HOWELL MI $18.28M
MERCY PHYSICIAN NETWORK MUSKEGON MI $11.14M
ST JOSEPH MERCY CHELSEA INC CHELSEA MI $6.89M
MERCY SPECIALTY SERVICES MUSKEGON MI $5.27M
MERCY HEALTH PARTNERS-OBSTETRICS AND GYNECOLOGY SPECIALIST MUSKEGON MI $1.67M
MERCY HEALTH WESTSHORE CARDIOLOGY SERVICES MUSKEGON MI $1.56M
MERCY HEALTH PARTNERS SUB-SPECIALTY SERVICES MUSKEGON MI $1.38M
SAINT MARY'S HEALTH SERVICES GRAND RAPIDS MI $1.22M
MERCY WOMEN'S HEALTH SERVICES MUSKEGON MI $1.08M
ST JOSEPH MERCY HOSPITAL YPSILANTI MI $653K
CHELSEA COMMUNITY HOSPITAL CHELSEA MI $597K
ST JOSEPH MERCY HOSPITAL CANTON MI $474K
SJMHS ANESTHESIA SERVICES YPSILANTI MI $459K
LAKES OBGYN SPECIALIST NORTON SHORES MI $425K
CHELSEA COMMUNITY HOSPITAL CHELSEA MI $223K
JOHNSON FAMILY CENTER FOR CANCER CARE MUSKEGON MI $156K
ST MARY MERCY HOSPITAL CRNA LIVONIA MI $102K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 16,355 $865K
2019 14,360 $810K
2020 9,040 $586K
2021 10,952 $725K
2022 11,915 $786K
2023 15,089 $865K
2024 17,464 $706K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 1,635 1,615 $1.22M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 11,983 11,417 $559K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 6,325 6,245 $447K
99232 Subsequent hospital care, per day, moderate complexity 8,728 3,899 $341K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 10,122 9,679 $313K
99223 Prolong inpt eval add15 m 2,839 2,574 $270K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 2,094 2,081 $267K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 3,569 3,548 $222K
99233 Prolong inpt eval add15 m 3,644 1,874 $202K
45380 Colonoscopy, flexible; with biopsy, single or multiple 2,119 2,103 $176K
99215 Prolong outpt/office vis 1,801 1,780 $132K
99222 Initial hospital care, per day, moderate complexity 1,922 1,742 $128K
99205 Prolong outpt/office vis 1,222 1,220 $116K
59514 139 135 $110K
59025 Fetal non-stress test 5,626 3,575 $94K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,864 1,853 $83K
99254 891 830 $81K
99231 Subsequent hospital care, per day, straightforward or low complexity 2,633 1,629 $56K
51700 1,698 934 $56K
99283 Emergency department visit for the evaluation and management, moderate severity 1,087 983 $47K
64615 700 699 $46K
99238 Hospital discharge day management, 30 minutes or less 1,125 1,091 $45K
45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) 413 408 $40K
99253 446 418 $28K
99464 637 636 $27K
62323 478 465 $24K
64405 449 444 $16K
99479 Subsequent intensive care, per day, very low birth weight infant 157 25 $13K
95886 422 300 $13K
64493 205 202 $13K
99282 Emergency department visit for the evaluation and management, low to moderate severity 503 475 $12K
99221 260 249 $12K
64483 185 167 $11K
99480 Subsequent intensive care, per day, low birth weight infant 103 14 $10K
95251 690 680 $10K
99220 112 107 $10K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 540 520 $8K
64495 202 199 $7K
99239 Hospital discharge day management, more than 30 minutes 125 125 $7K
64494 202 199 $7K
91200 995 982 $6K
51784 219 130 $6K
64400 210 199 $6K
81002 2,669 1,862 $5K
20553 393 389 $5K
62321 98 95 $5K
99284 Emergency department visit for the evaluation and management, high severity 68 64 $5K
64484 151 135 $4K
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 32 32 $3K
99495 55 53 $3K
51798 551 536 $3K
99152 318 298 $2K
43235 24 24 $2K
99244 Office or other outpatient consultation, moderate to high complexity 16 16 $1K
97032 168 72 $953.27
27096 13 13 $927.03
95910 14 13 $897.08
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 29 29 $796.93
64566 21 12 $747.81
99406 111 109 $651.54
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 28 28 $515.76
43450 25 25 $462.37
99442 27 27 $388.91
95819 12 12 $332.45
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) 56 56 $127.78
97750 25 12 $64.74
3074F 3,172 3,126 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 269 266 $0.00
3075F 670 665 $0.00
3079F 1,144 1,136 $0.00
3080F 235 235 $0.00
3044F 12 12 $0.00
99024 44 31 $0.00
3077F 397 396 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 145 144 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 16 16 $0.00
3078F 2,836 2,789 $0.00
3051F 12 12 $0.00