Physician
Mercy Health Partners - Physician Specialist
Mercy Health Partners - Physician Specialist was paid $5.34M by Medicaid between Jan 2018 and Dec 2024, across 78 billing codes. Its largest line is 59409, Vaginal delivery only (with or without episiotomy and/or forceps) — 23% of everything it billed.
33Billing provider infoMERCY HEALTH PARTNERS - PHYSICIAN SPECIALIST
MUSKEGON, MI 49442
MUSKEGON, MI 49442
33aNPI1922248772assigned 03/05/2009
33bProvider typeCardiovascular Disease Physician
28Total paid$5.34M
24GClaims95,175
24DCodes billed78
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Cardiovascular Disease Physician providers in Michigan
Rank by total paid#5 of 134
Median peer was paid$91K
This provider vs. median58×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official GUSHO, MICHAEL controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
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
| Year | Claims | 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 | |
| 2024incomplete | 17,464 | $706K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 23% | 1,635 | 1,615 | $1.22M |
| 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 | 10% | 11,983 | 11,417 | $559K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 8.4% | 6,325 | 6,245 | $447K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 6.4% | 8,728 | 3,899 | $341K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.9% | 10,122 | 9,679 | $313K |
| 99223 | Prolong inpt eval add15 m | 5.1% | 2,839 | 2,574 | $270K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 5.0% | 2,094 | 2,081 | $267K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 4.2% | 3,569 | 3,548 | $222K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 3.8% | 3,644 | 1,874 | $202K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 3.3% | 2,119 | 2,103 | $176K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 2.5% | 1,801 | 1,780 | $132K |
| 99222 | Initial hospital care, per day, moderate complexity | 2.4% | 1,922 | 1,742 | $128K |
66 more codes
| 99205 | Prolong outpt/office vis | 2.2% | 1,222 | $116K |
| 59514 | 2.1% | 139 | $110K | |
| 59025 | Fetal non-stress test | 1.8% | 5,626 | $94K |
| 99203 | Doctor's office visit, new patient (routine) | 1.5% | 1,864 | $83K |
| 99254 | 1.5% | 891 | $81K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.1% | 2,633 | $56K |
| 51700 | 1.0% | 1,698 | $56K | |
| 99283 | Emergency room visit (moderate) | <1% | 1,087 | $47K |
| 64615 | <1% | 700 | $46K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 1,125 | $45K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 413 | $40K |
| 99253 | <1% | 446 | $28K | |
| 99464 | <1% | 637 | $27K | |
| 62323 | <1% | 478 | $24K | |
| 64405 | <1% | 449 | $16K | |
| 99479 | Subsequent intensive care, per day, very low birth weight infant | <1% | 157 | $13K |
| 95886 | <1% | 422 | $13K | |
| 64493 | <1% | 205 | $13K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 503 | $12K |
| 99221 | <1% | 260 | $12K | |
| 64483 | <1% | 185 | $11K | |
| 99480 | Subsequent intensive care, per day, low birth weight infant | <1% | 103 | $10K |
| 95251 | <1% | 690 | $10K | |
| 99220 | <1% | 112 | $10K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 540 | $8K |
| 64495 | <1% | 202 | $7K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 125 | $7K |
| 64494 | <1% | 202 | $7K | |
| 91200 | <1% | 995 | $6K | |
| 51784 | <1% | 219 | $6K | |
| 64400 | <1% | 210 | $6K | |
| 81002 | <1% | 2,669 | $5K | |
| 20553 | <1% | 393 | $5K | |
| 62321 | <1% | 98 | $5K | |
| 99284 | Emergency room visit (serious) | <1% | 68 | $5K |
| 64484 | <1% | 151 | $4K | |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | <1% | 32 | $3K |
| 99495 | <1% | 55 | $3K | |
| 51798 | <1% | 551 | $3K | |
| 99152 | <1% | 318 | $2K | |
| 43235 | <1% | 24 | $2K | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 16 | $1K |
| 97032 | <1% | 168 | $953.27 | |
| 27096 | <1% | 13 | $927.03 | |
| 95910 | <1% | 14 | $897.08 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 29 | $796.93 |
| 64566 | <1% | 21 | $747.81 | |
| 99406 | <1% | 111 | $651.54 | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 28 | $515.76 |
| 43450 | <1% | 25 | $462.37 | |
| 99442 | <1% | 27 | $388.91 | |
| 95819 | <1% | 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) | <1% | 56 | $127.78 |
| 97750 | <1% | 25 | $64.74 | |
| 3074F | 0% | 3,172 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 269 | $0.00 |
| 3075F | 0% | 670 | $0.00 | |
| 3079F | 0% | 1,144 | $0.00 | |
| 3080F | 0% | 235 | $0.00 | |
| 3044F | 0% | 12 | $0.00 | |
| 99024 | 0% | 44 | $0.00 | |
| 3077F | 0% | 397 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 145 | $0.00 |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 16 | $0.00 |
| 3078F | 0% | 2,836 | $0.00 | |
| 3051F | 0% | 12 | $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 officialGUSHO, MICHAEL (CHIEF FINANCIAL OFFICER)
Parent organizationMERCY HEALTH PARTNERS
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.