Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Michigan for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Michigan only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Michigan (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Edward W Sparrow Hospital Association (NPI 1073588711)

Field	Value
Entity Type	Organization
Organization	Edward W Sparrow Hospital Association
Address	1215 E Michigan Ave
City	Lansing
State	MI
ZIP	48912
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 17, 2006

Payer Source	Total Paid
Medicaid	$126M
Medicare	$0

Key Findings

EDWARD W SPARROW HOSPITAL ASSOCIATION is effectively a Medicaid-focused provider: it reports Total Medicaid revenue of $126M and has no Medicare billing on file. This makes the provider functionally single‑payer in the supplied data set, concentrating its fee-for-service billing activity within state Medicaid programs rather than Medicare.

Revenue concentration is high and centered on emergency and outpatient evaluation services: the precomputed top 3 Medicaid codes (99285, G0463, 99284) account for 59.0% of the provider's total Medicaid revenue, with 99285 generating $26M (27.9%), G0463 $16.6M (17.8%), and 99284 $12.4M (13.3%). This level of concentration indicates that a small set of visit-based codes drive the majority of reported Medicaid dollars.

The code mix and dollar concentration point to a hospital operating large emergency and hospital outpatient clinic volumes: 99285 (high‑acuity ED E/M), 99284 (moderate‑acuity ED E/M), and G0463 (hospital outpatient clinic visit) are the top revenue drivers. In addition to ED visits and clinic visits, the provider also bills substantial volumes for IV drug administration (96374, 96365, 96375, 96360, 96361) and therapeutic/rehab services (97530, 97110), consistent with an acute care hospital providing emergency stabilization, outpatient treatments, and rehabilitation.

Competitive standing within Michigan is strong for several high‑value codes: 99285 ranks #16 of 404 providers in-state (96th percentile) and is described as notably above typical state volume for this code, marking the hospital as a major regional provider of high‑acuity ED care. 99284 ranks #28 of 477 (94th percentile) and 99283 ranks #23 of 447 (95th percentile), both indicating above‑average ED activity versus other in-state providers.

The provider shows unusually high volume in certain ancillary and diagnostic services: 87637 (multiplex SARS‑CoV‑2/influenza/RSV testing) is an extreme outlier at rank #4 of 126 providers in-state (98th percentile), and U0003 (SARS‑CoV‑2 NAAT) ranks #7 of 157 (96th percentile), together reflecting very large respiratory testing throughput during the period captured. High ranks for imaging codes such as 74177 ($2M, rank #15 of 229, 94th percentile) and 70450 ($1.7M, rank #18 of 225, 92th percentile) further indicate significant outpatient diagnostic imaging activity.

Operationally, the hospital bills substantial volumes for ambulatory rehab and therapy: 97530 accounts for $1.7M (1.8% of Medicaid revenue) and ranks #10 of 388 in-state (98th percentile), while 97110 reports $1.3M and ranks #12 of 547 (98th percentile). These placements suggest a robust outpatient therapy program that complements the ED and clinic visit volumes.

Several medication administration and infusion codes are both high-volume and rank notably above peers (96374 ranks #7 of 148, 96th percentile; 96365 ranks #4 of 165, 98th percentile; 96375 ranks #6 of 155, 97th percentile), indicating frequent IV/infusion therapy delivered in ED or outpatient settings. Together with significant chemo administration code 96413 ($781.1K) and chemo/infusion infrastructure, the pattern is consistent with a facility that manages high throughput infusion and IV medication services.

Provider tenure is long and supports an established presence: the NPI was enumerated on 2006-02-17 (~20 years ago), indicating the organization has been active in claims reporting for approximately two decades. This longevity, coupled with high statewide percentiles across multiple service lines, underscores an entrenched role in Michigan’s Medicaid delivery system.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

711 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	71,660	$360	$26M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	263,890	$60	$16.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	60,030	$210	$12.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	64,980	$130	$8.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	43,400	$90	$4.1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	16,980	$120	$2M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	20,880	$90	$1.9M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	16,340	$110	$1.7M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	47,660	$40	$1.7M
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…	52,930	$30	$1.7M

Showing 1–10 of 711

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.

Claims Volume vs. Michigan Distribution

Edward W Sparrow Hospital Association — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

711 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	150	5,330	$50	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	16	400	1,510	$190	$2.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	28	480	1,350	$110	$1.7M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	12	10	440	$970	$1.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	23	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	10	100	2,820	$180	$1.1M
J2505	Injection, pegfilgrastim, 6 mg	11	10	130	$2,420	$942.2K
J0585	Injection, onabotulinumtoxina, 1 unit	34	40	260	$510	$684.9K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	27	30	300	$920	$652.6K

Showing 1–10 of 711

Related Providers

Other providers that share a Tax Identification Number (TIN) with Edward W Sparrow Hospital Association, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Edward W. Sparrow Hospital Association	MI	Obstetrics & Gynecology Physician	$0	$5.8M
Edward W. Sparrow Hospital Association	MI	Urgent Care Clinic/Center	$0	$5.4M
Kourosh Naeini	CA	Diagnostic Radiology Physician	$709.1K	$120
Abbas Chamsuddin	IL	Diagnostic Radiology Physician	$368.8K	$114.2K
Michael Benanti	IL	Diagnostic Radiology Physician	$469.7K	$460
Daniel Lucas	AZ	Diagnostic Radiology Physician	$298.3K	$164.6K
Kamiar Massrour	AZ	Diagnostic Radiology Physician	$211.3K	$227.7K
Eyad Abu-isa	MI	Radiation Oncology Physician	$409K	$0
Supriya Gupta	IL	Diagnostic Radiology Physician	$199.2K	$166K

Nearby Providers

Other providers in the same ZIP code as Edward W Sparrow Hospital Association, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Residential Options, Inc.	MI	Behavior Analyst	$0	$53.8M
Lansing Urgent Care Plc	MI	Urgent Care Clinic/Center	$0	$27.5M
Vituity - Michigan Em PC	MI	Emergency Medicine Physician	$0	$9.9M
Lansing Radiology Associates P C	MI	Diagnostic Radiology Physician	$0	$8.2M
Epmg Western Michigan PLLC	MI	Emergency Medicine Physician	$0	$7.4M
Lansing Mercy Ambulance Service, Inc.	MI	Land Ambulance	$466.7K	$2.3M
Christopher Sweet	MI	Diagnostic Radiology Physician	$1.3M	$0
Lake Lansing Asc Partners LLC	MI	Ambulatory Surgical Clinic/Center	$373.3K	$263.6K
Yuelin Xu	MI	Procedural Dermatology Physician	$418.6K	$0
Gregory Messenger	MI	Dermatology Physician	$303.2K	$0

Edward W Sparrow Hospital Association — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References