Medicaid Provider Spending

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

ST JOSEPH MERCY CHELSEA INC

NPI: 1992761985 · CHELSEA, MI 48118 · General Acute Care Hospital · NPI assigned 04/26/2006

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

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

$6.89M
Total Medicaid Paid
191,323
Total Claims
173,226
Beneficiaries
158
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGUSHO, MICHAEL (SR REIMBURSEMENT MANAGEMENT ANALYST)
NPI Enumeration Date04/26/2006

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
MERCY HEALTH PARTNERS - PHYSICIAN SPECIALIST MUSKEGON MI $5.34M
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 18,495 $703K
2019 17,786 $672K
2020 21,189 $826K
2021 32,786 $1.26M
2022 34,951 $1.19M
2023 39,473 $1.30M
2024 26,643 $933K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 5,677 5,356 $2.09M
99284 Emergency department visit for the evaluation and management, high severity 5,949 5,690 $1.23M
99283 Emergency department visit for the evaluation and management, moderate severity 5,136 5,000 $650K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 6,148 5,674 $589K
74177 Computed tomography, abdomen and pelvis; with contrast material 2,382 2,313 $321K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 3,289 3,012 $247K
96375 Therapeutic injection; each additional sequential IV push 5,332 4,450 $172K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1,402 1,332 $131K
99282 Emergency department visit for the evaluation and management, low to moderate severity 1,943 1,877 $129K
96361 Intravenous infusion, hydration; each additional hour 4,129 3,543 $125K
71046 Radiologic examination, chest; 2 views 3,250 3,140 $120K
70450 Computed tomography, head or brain; without contrast material 788 778 $80K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 241 241 $79K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 1,068 1,057 $78K
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 1,262 1,233 $75K
80061 Lipid panel 1,757 1,749 $57K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 532 477 $54K
77067 Screening mammography, bilateral, including computer-aided detection 936 935 $46K
20610 245 228 $39K
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 77 77 $37K
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 1,715 1,645 $36K
76705 Ultrasound, abdominal, real time with image documentation; limited 585 578 $35K
71045 Radiologic examination, chest; single view 872 831 $35K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 1,900 1,738 $29K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 1,220 406 $26K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,070 1,062 $26K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2,380 2,210 $22K
76830 Ultrasound, transvaginal 357 350 $21K
80053 Comprehensive metabolic panel 11,396 10,153 $21K
84443 Thyroid stimulating hormone (TSH) 3,564 3,464 $19K
93975 159 155 $19K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 401 394 $19K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1,056 350 $18K
74176 Computed tomography, abdomen and pelvis; without contrast material 143 143 $16K
G0378 Hospital observation service, per hour 800 736 $16K
45380 Colonoscopy, flexible; with biopsy, single or multiple 25 25 $14K
71275 Computed tomographic angiography, chest, with contrast material 135 132 $13K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 12,601 10,966 $13K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 461 440 $11K
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 554 544 $10K
71260 Computed tomography, thorax, diagnostic; with contrast material 66 65 $10K
85027 3,313 3,038 $8K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 48 31 $7K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,455 1,129 $7K
82728 550 546 $5K
80048 Basic metabolic panel (calcium, ionized) 3,527 3,189 $5K
83036 Hemoglobin; glycosylated (A1C) 783 779 $5K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 230 229 $4K
70496 33 28 $4K
77063 Screening digital breast tomosynthesis, bilateral 316 316 $4K
73630 326 322 $3K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 4,716 4,075 $3K
84439 864 833 $3K
36415 Collection of venous blood by venipuncture 7,708 7,169 $3K
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 77 77 $3K
84466 309 308 $2K
82607 255 255 $2K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 177 175 $2K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 176 174 $2K
86900 448 402 $2K
84702 2,070 1,951 $2K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 13 12 $2K
83735 2,928 2,400 $2K
87428 48 48 $2K
83540 394 392 $2K
72100 67 66 $2K
0012A 51 50 $1K
93971 29 28 $1K
86140 958 899 $1K
G0475 Hiv antigen/antibody, combination assay, screening 78 78 $1K
86850 433 414 $1K
87086 Culture, bacterial; quantitative colony count, urine 873 835 $1K
84703 2,663 2,549 $1K
73030 148 144 $1K
73610 112 109 $1K
90837 Psychotherapy, 53 minutes with patient 14 14 $1K
85610 1,340 1,245 $1K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 43 39 $966.99
76770 12 12 $959.40
0011A 55 55 $928.24
73110 47 42 $913.67
73130 54 52 $881.43
71271 12 12 $702.51
Q3014 Telehealth originating site facility fee 44 42 $652.61
85652 788 748 $652.34
97161 14 14 $587.30
83690 3,298 3,061 $573.61
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 219 215 $570.52
85730 491 483 $562.37
80076 330 313 $549.52
81001 4,071 3,852 $535.83
73564 24 24 $488.63
74018 27 24 $486.29
83880 143 139 $453.96
86901 450 403 $380.46
72125 Computed tomography, cervical spine; without contrast material 26 26 $363.80
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 32 28 $329.18
81003 2,295 2,225 $293.69
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 26 26 $274.56
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 195 191 $266.19
73562 28 26 $239.19
85379 1,078 1,048 $226.70
86780 13 13 $113.72
84484 2,951 2,489 $109.88
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 133 127 $95.80
83605 730 658 $95.64
88142 12 12 $86.90
87340 12 12 $81.72
82248 62 56 $71.13
87081 62 62 $68.08
J2704 Injection, propofol, 10 mg 3,420 3,172 $61.32
82570 12 12 $39.70
85007 69 55 $37.21
87186 25 24 $36.68
J7120 Ringers lactate infusion, up to 1000 cc 4,289 3,792 $30.66
82565 13 13 $20.16
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 2,512 2,414 $17.00
84100 46 36 $15.10
J2405 Injection, ondansetron hydrochloride, per 1 mg 5,161 4,597 $12.90
87077 16 16 $11.48
J7030 Infusion, normal saline solution , 1000 cc 3,788 3,283 $9.97
J1885 Injection, ketorolac tromethamine, per 15 mg 4,515 3,931 $4.92
J1170 Injection, hydromorphone, up to 4 mg 1,152 919 $3.18
96376 1,280 902 $2.99
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 204 176 $1.34
J2270 Injection, morphine sulfate, up to 10 mg 972 817 $0.00
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,390 1,222 $0.00
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 99 95 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 576 527 $0.00
A9575 Injection, gadoterate meglumine, 0.1 ml 193 185 $0.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg 52 52 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 15 13 $0.00
84145 12 12 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 146 146 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 3,237 3,032 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 2,658 2,532 $0.00
J7050 Infusion, normal saline solution, 250 cc 654 477 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 234 211 $0.00
J0690 Injection, cefazolin sodium, 500 mg 985 814 $0.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg 2,864 2,580 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 105 105 $0.00
J2765 Injection, metoclopramide hcl, up to 10 mg 313 289 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 121 120 $0.00
J3490 Unclassified drugs 641 464 $0.00
83520 210 183 $0.00
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 269 197 $0.00
J2060 Injection, lorazepam, 2 mg 127 95 $0.00
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 104 59 $0.00
82803 43 41 $0.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 13 12 $0.00
A9270 Non-covered item or service 296 89 $0.00
87430 13 13 $0.00
87040 46 37 $0.00
70498 32 27 $0.00
J1630 Injection, haloperidol, up to 5 mg 12 12 $0.00
G0283 Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care 46 14 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 21 13 $0.00
J2795 Injection, ropivacaine hydrochloride, 1 mg 12 12 $0.00