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.

Sparrow Clinton Hospital (NPI 1093809824)

Sparrow Clinton Hospital is a critical access hospital provider located in Saint Johns, Michigan. This profile covers 0 Medicare and 132 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Sparrow Clinton Hospital
Address	805 S Oakland St
City	Saint Johns
State	MI
ZIP	48879
Taxonomy	Critical Access Hospital
NPI Enumerated	October 3, 2006

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

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

132 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.	6,900	$360	$2.5M
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.	6,520	$230	$1.5M
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.	7,920	$150	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7,490	$90	$643.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	4,610	$120	$562.8K
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.	2,300	$180	$411.2K
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.	1,890	$120	$217.8K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	3,940	$40	$157.4K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	1,810	$80	$150K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,430	$20	$147.9K

Showing 1–10 of 132

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

Sparrow Clinton Hospital — 0 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

132 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	70	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.	123	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.	169	480	1,350	$110	$1.7M
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.	164	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.	93	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	90	100	2,820	$180	$1.1M
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…	92	160	2,720	$60	$546.6K
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.	117	230	2,380	$90	$490K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	84	140	5,720	$40	$381.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	153	260	2,670	$70	$348.7K

Showing 1–10 of 132

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vishal Saini	MI	Sleep Medicine (Family Medicine) Physician	$142.8K	$0
Eric Nelson	SC	Anesthesiology Physician	$17K	$0
William Peterson	MI	Anesthesiology Physician	$6.5K	$0
Ashley Agerson	MI	Anesthesiology Physician	$2.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clinton County Medical Center Psychological Services PLLC	MI	Mental Health Counselor	$0	$10.7M
Clinton Area Ambulance Service Authority	MI	Land Ambulance	$296.5K	$706K
Ogochukwu Azuh	MI	Physical Medicine & Rehabilitation Physician	$21.7K	$0
Bryanna Weber	MI	Physician Assistant	$15K	$0

Sparrow Clinton Hospital — Billing Profile & Reimbursement Data

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Sparrow Clinton Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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