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 1477509313)

Edward W. Sparrow Hospital Association is a urgent care clinic/center provider located in East Lansing, Michigan. This profile covers 0 Medicare and 66 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	Edward W. Sparrow Hospital Association
Address	2682 E Grand River Ave
City	East Lansing
State	MI
ZIP	48823
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	May 25, 2006

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	52,290	$40	$2.1M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	37,360	$60	$2.1M
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	14,520	$50	$740.4K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	2,120	$80	$163.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	3,130	$40	$115.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	7,010	$10	$84.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,720	$30	$73.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	3,170	$10	$41.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1,680	$10	$15.1K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	1,230	$10	$7.4K

Showing 1–10 of 66

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 — 5 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

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	66	4,380	1,000	$70	$289.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	69	4,770	1,060	$50	$247.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,030	1,170	170	$90	$107.9K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	216	1,860	220	$90	$96.9K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	30	2,000	260	$60	$84.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	451	1,420	590	$20	$57.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	173	1,690	230	$30	$36.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	191	430	890	$1	$32.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	31	720	120	$50	$29.2K
J7626	Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg	6	10	40	$20	$26.6K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward W Sparrow Hospital Association	MI	General Acute Care Hospital	$0	$126M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Edward W. Sparrow Hospital Association	MI	Obstetrics & Gynecology Physician	$0	$5.8M
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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cypress Home Care, Inc.	MI	Home Health Agency	$0	$9.1M
Pine Hollow Partner LLC	MI	Nurse Practitioner	$0	$7.1M
Michigan State University	MI	Behavior Analyst	$0	$5.6M
Ahmed El-sanhouri	MI	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
O'neil Biscette	MI	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Ashim Aggarwal	MI	Ophthalmology Physician	$1.3M	$0
Michigan Surgical Center,llc	MI	Ambulatory Surgical Clinic/Center	$1.1M	$157.2K
Richard Pittsley	MI	Rheumatology Physician	$765.8K	$0
Julia Hobson	MI	Diagnostic Radiology Physician	$367.1K	$0
Scott Piette	MI	Glaucoma Specialist (Ophthalmology) Physician	$341.9K	$0

Edward W. Sparrow Hospital Association — 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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