Providers
MICHAEL RODNEY QUION, M.D.
NPI 1326018342, individual, Berrien Springs, MI, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 6 months, but with up to 157 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99213 ($586 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7850, $914K at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Oct 2018 | More hours than a day holds at a conservative unit price | 1.9 | 39.8 | 26.5 | 35.8 | 127 | 1 | 99213 99214 | $60K |
| Jan 2019 | More hours than a day holds at a conservative unit price | 2.0 | 53.8 | 35.9 | 48.4 | 144 | 1 | 99212 99213 99214 | $70K |
| Feb 2019 | More hours than a day holds at a conservative unit price | 1.4 | 38.1 | 25.4 | 35.6 | 95 | 1 | 99213 99214 | $43K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 1.5 | 41.7 | 27.8 | 41.1 | 113 | 1 | 99213 99214 | $52K |
| May 2019 | More hours than a day holds at a conservative unit price | 2.0 | 49.2 | 32.8 | 44.2 | 143 | 1 | 99213 99214 | $64K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 2.1 | 50.5 | 33.6 | 50.5 | 145 | 1 | 99213 99214 | $65K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MICHAEL RODNEY QUION, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | January 23, 2006, last updated May 12, 2021 |
| Practice location | 9045 US HIGHWAY 31 STE A, Berrien Springs, MI 49103-1804, 269-473-2222 |
| Specialties | Family Medicine (207Q00000X, primary, license 4301070716 MI) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $630K | 54% | $333 | $44 (top 5% from $110) | 99th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $263K | 23% | $238 | $60 (top 5% from $133) | 99th percentile | |
| T1015 | Medicaid service code | $217K | 19% | $586 | $182 (top 5% from $488) | 97th percentile | |
| 86703 | Analysis for antibody to hiv-1 and hiv-2 virus | $17K | 1% | $265 | $11 (top 5% from $20) | too few months to rank | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $16K | 1% | $237 | $67 (top 5% from $121) | too few months to rank | |
| 87650 | Detection test by nucleic acid for strep (streptococcus, group a), direct probe technique | $6K | 1% | $199 | $18 (top 5% from $36) | too few months to rank | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $6K | 0% | $467 | $28 (top 5% from $147) | too few months to rank | |
| 80305 | Testing for presence of drug, read by direct observation | $4K | 0% | $289 | $9.23 (top 5% from $22) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 243 | 118 | $19K | $257 | $126 | 2.0x | 2.3x (90th percentile 3.8x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 53 | 53 | $7K | $234 | $131 | 1.8x | 2.3x (90th percentile 4.1x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 106 | 84 | $5K | $171 | $89 | 1.9x | 2.2x (90th percentile 3.8x) |
| 36415 | Insertion of needle into vein for collection of blood sample | 138 | 92 | $1K | $20 | $9 | 2.3x | 2.0x (90th percentile 3.5x) |
| 80053 | Blood test, comprehensive group of blood chemicals | 112 | 89 | $1K | $56 | $10 | 5.5x | 3.7x (90th percentile 7.4x) |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 65 | 63 | $840 | $64 | $13 | 5.0x | 3.5x (90th percentile 6.9x) |
| 83036 | Hemoglobin a1c level | 76 | 65 | $714 | $43 | $9 | 4.6x | 3.5x (90th percentile 6.9x) |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 43 | 36 | $691 | $71 | $16 | 4.4x | 3.3x (90th percentile 5.5x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
4 providers in Berrien County, MI carry an indicator in the public record, with $364K at stake between them. The most common is part of a provider network, on 4 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC Benton Harbor, MI, ranked 1204 | $354K |
|
| 3 | HOSPICE AT HOME, INC. Saint Joseph, MI, ranked 1553 | $10K |
|
| 3 | MERCY MEMORIAL HEALTH SERVICES INC Stevensville, MI, ranked 4408 | $0 |
|
| 3 | GIVA TILLMAN - ADKINS Niles, MI, ranked 6855 | $0 |
|
Recent enforcement in MI
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
National Health Care Fraud Enforcement Action Results in 455 Defendants Charged and Over $6.5 Billion in Intended Fraud Loss Charged
Six cases in the Eastern District of Michigan involving alleged fraudulent billing of Medicare, Medicaid and private insurers for laboratory tests, prescriptions not dispensed, and reimbursement claims for services never rendered, plus unlawful opioid prescribing and False Claims Act settlements.
DOJConvictedMay 15, 2026
Michigan Home Health Care Agency Owner Convicted of $1.6M Medicare Fraud Scheme and Kickback Conspiracy
Scott bribed a hospital discharge nurse to fax confidential Medicare patient records to her home health agency and billed Medicare for home health services using false representations that doctors had certified the patients as homebound, causing approximately $1.6 million in losses.
DOJPleaded guiltyMay 1, 2026
Pharmacy Technician Pleads Guilty to $5.6M Health Care Fraud Scheme and Illegal Distribution of Oxycodone
A pharmacy technician and a co-conspirator submitted false claims to health care benefit programs for prescription drugs that were never ordered by a doctor and never dispensed, using forged prescriptions, and he provided unlawful oxycodone prescriptions to drug traffickers for cash.
DOJSentencedNov 24, 2025
Michigan Pharmacist Sentenced to 46 Months in Prison for $4M Health Care Fraud Scheme
Fakih billed Medicare for prescription medications, such as blood thinners and lung disease inhalers, that he did not dispense at the pharmacy he owned and operated, concealing the fraud by manipulating inventory purchases and diverting proceeds for personal use.
DOJSentencedNov 21, 2025
Pharmacist and Brother Sentenced to Prison for $15M Health Care and Wire Fraud Scheme
A pharmacist and his brother, a pharmacy manager, billed Medicare, Medicaid and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated, targeting expensive medications and concealing inventory shortages from auditors.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.