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 Ionia Hospital (NPI 1700820065)

Sparrow Ionia Hospital is a critical access hospital provider located in Ionia, Michigan. This profile covers 0 Medicare and 157 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 Ionia Hospital
Address	3565 S State Rd
City	Ionia
State	MI
ZIP	48846
Taxonomy	Critical Access Hospital
NPI Enumerated	June 16, 2006

Payer Source	Total Paid
Medicaid	$13.7M
Medicare	$0

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

157 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.	10,990	$350	$3.9M
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.	10,830	$220	$2.4M
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.	12,870	$150	$1.9M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7,000	$120	$819.5K
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.	2,880	$160	$452.8K
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.	3,970	$110	$440.1K
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…	7,170	$50	$380K
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…	7,080	$40	$290.4K
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…	9,240	$30	$277.1K
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.	2,850	$90	$251K

Showing 1–10 of 157

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 Ionia 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

157 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	96	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.	135	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.	125	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.	76	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	70	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…	46	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.	105	230	2,380	$90	$490K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	253	270	510	$140	$395.2K
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.	74	140	5,720	$40	$381.8K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	81	90	1,270	$120	$367.8K

Showing 1–10 of 157

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rafid Yousif	MI	Urology Physician	$202.4K	$0
Gabriel Elia	MI	Nephrology Physician	$161.3K	$0
Vishal Saini	MI	Sleep Medicine (Family Medicine) Physician	$142.8K	$0
Jeffrey Martindale	MI	Cardiovascular Disease Physician	$115.2K	$0
Roy Miller	MI	Urology Physician	$78.7K	$0
Asad Mehboob	AR	Gastroenterology Physician	$69.2K	$0
Drue Orwig	MI	Emergency Medicine Physician	$50.7K	$0
Carlos Fernandez	MI	Interventional Cardiology Physician	$49.2K	$0
Jamie Bartley	MI	Urology Physician	$38.6K	$0
Rachel Seavolt	MI	Family Nurse Practitioner	$33.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ionia County Community Mental Health	MI	Public Health or Welfare Agency	$0	$93.9M
Life Ems Of Ionia Co Inc	MI	Land Ambulance	$1.9M	$10.8M
John Birgiolas	MI	Interventional Pain Medicine Physician	$172.8K	$0

Sparrow Ionia 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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