Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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PRISMA HEALTH-UPSTATE

NPI: 1063968196 · SENECA, SC 29672 · General Acute Care Hospital · NPI assigned 08/29/2016

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official MILLER, POLLY controls 20+ related entities in our dataset. Read more

$15.64M
Total Medicaid Paid
680,726
Total Claims
573,395
Beneficiaries
253
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMILLER, POLLY (VP PAYOR STRATEGIES & ALIGNMENT)
NPI Enumeration Date08/29/2016

Related Entities

Other providers sharing the same authorized official: MILLER, POLLY

ProviderCityStateTotal Paid
PRISMA HEALTH-MIDLANDS COLUMBIA SC $74.58M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $68.26M
PRISMA HEALTH-UPSTATE GREENVILLE SC $25.04M
PRISMA HEALTH-UPSTATE GREENVILLE SC $21.98M
PRISMA HEALTH-UPSTATE GREENVILLE SC $19.69M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $11.77M
PRISMA HEALTH-UPSTATE GREENVILLE SC $10.74M
GREENVILLE HEALTH CORPORATION GREENVILLE SC $8.90M
PRISMA HEALTH-UPSTATE GREENVILLE SC $8.32M
PRISMA HEALTH-UPSTATE GREENVILLE SC $7.45M
PRISMA HEALTH UNIVERSITY MEDICAL GROUP GREENVILLE SC $7.44M
PRISMA HEALTH-MIDLANDS COULMBIA SC $7.43M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $6.88M
PRISMA HEALTH TUOMEY SUMTER SC $6.84M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $6.77M
PRISMA HEALTH-UPSTATE GREENVILLE SC $6.37M
PRISMA HEALTH-UPSTATE GREENVILLE SC $5.00M
PRISMA HEALTH-UPSTATE GREENVILLE SC $4.65M
PRISMA HEALTH-MIDLANDS COLUMBIA SC $4.63M
PRISMA HEALTH-UPSTATE SENECA SC $4.48M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 89,417 $2.06M
2019 101,832 $2.00M
2020 95,960 $2.06M
2021 101,041 $2.33M
2022 104,428 $2.66M
2023 98,771 $2.52M
2024 89,277 $2.02M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
36415 Collection of venous blood by venipuncture 47,939 35,599 $4.13M
99283 Emergency department visit for the evaluation and management, moderate severity 32,067 29,635 $1.15M
99282 Emergency department visit for the evaluation and management, low to moderate severity 7,667 7,404 $1.01M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 11,316 7,126 $732K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 7,038 6,726 $575K
96361 Intravenous infusion, hydration; each additional hour 12,754 9,690 $451K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 6,412 2,212 $446K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 4,913 4,593 $371K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 11,517 10,246 $340K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 5,267 4,435 $308K
81025 11,087 10,228 $308K
81001 18,163 16,361 $307K
80053 Comprehensive metabolic panel 24,213 21,074 $306K
92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder 4,674 1,926 $292K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 3,456 3,211 $248K
82565 735 671 $180K
71260 Computed tomography, thorax, diagnostic; with contrast material 869 844 $175K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 6,374 5,679 $162K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 202 199 $161K
87086 Culture, bacterial; quantitative colony count, urine 9,696 8,921 $158K
86850 2,602 2,389 $139K
71046 Radiologic examination, chest; 2 views 6,850 6,506 $137K
99284 Emergency department visit for the evaluation and management, high severity 18,446 17,059 $133K
80048 Basic metabolic panel (calcium, ionized) 16,561 12,537 $129K
97530 Therapeutic activities, direct patient contact, each 15 minutes 4,900 1,728 $129K
99281 Emergency department visit for the evaluation and management, self-limited or minor 931 883 $127K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,246 1,192 $125K
70450 Computed tomography, head or brain; without contrast material 4,632 4,319 $125K
87081 3,446 3,368 $120K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,784 1,728 $118K
73130 1,235 1,191 $116K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 2,302 2,204 $99K
76830 Ultrasound, transvaginal 678 660 $95K
81003 4,963 4,661 $94K
74177 Computed tomography, abdomen and pelvis; with contrast material 4,940 4,690 $91K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 18,389 16,407 $89K
73110 989 957 $87K
73610 1,694 1,638 $84K
87077 4,182 3,985 $83K
73630 1,732 1,657 $80K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 2,442 1,603 $78K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 14,945 12,662 $76K
76705 Ultrasound, abdominal, real time with image documentation; limited 1,928 1,843 $71K
74176 Computed tomography, abdomen and pelvis; without contrast material 2,212 2,127 $65K
71045 Radiologic examination, chest; single view 8,719 7,810 $65K
76801 602 528 $65K
87210 1,642 1,547 $62K
87070 1,654 1,587 $54K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,109 1,088 $53K
71250 268 263 $52K
73030 1,172 1,109 $49K
93971 375 365 $45K
80047 2,022 1,944 $37K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 39,178 30,437 $34K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,484 1,455 $33K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 1,941 1,870 $33K
12001 297 293 $31K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 590 564 $27K
96376 4,460 2,800 $27K
71275 Computed tomographic angiography, chest, with contrast material 1,360 1,256 $27K
G0378 Hospital observation service, per hour 5,389 4,304 $26K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 153 145 $26K
96375 Therapeutic injection; each additional sequential IV push 9,371 7,615 $25K
72100 800 787 $24K
73564 654 623 $23K
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 throughput technologies as described by cms-2020-01-r 1,851 1,684 $21K
73090 244 235 $21K
93017 436 420 $21K
59025 Fetal non-stress test 427 268 $19K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 2,979 1,694 $18K
74018 537 499 $16K
77067 Screening mammography, bilateral, including computer-aided detection 555 553 $15K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 29 29 $15K
84112 56 52 $15K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 891 865 $13K
88304 294 292 $12K
73080 167 165 $12K
J7120 Ringers lactate infusion, up to 1000 cc 7,648 6,860 $12K
U0005 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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 944 871 $12K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 669 500 $11K
80061 Lipid panel 3,535 3,413 $11K
73502 542 499 $11K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 8,254 7,582 $9K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,158 2,108 $9K
82950 920 884 $9K
80076 3,211 2,931 $8K
84443 Thyroid stimulating hormone (TSH) 5,893 5,669 $8K
0202U Oncology (prostate), multianalyte, gene expression profiling 43 42 $8K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 3,699 2,968 $8K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 3,223 3,034 $7K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 848 799 $7K
81511 13 12 $6K
J2550 Injection, promethazine hcl, up to 50 mg 2,069 1,694 $6K
76770 114 112 $6K
J7030 Infusion, normal saline solution , 1000 cc 14,011 11,042 $6K
J1650 Injection, enoxaparin sodium, 10 mg 3,251 1,308 $6K
73560 135 130 $5K
77063 Screening digital breast tomosynthesis, bilateral 56 56 $5K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 3,063 2,884 $5K
87807 393 387 $5K
84702 2,928 2,469 $4K
93225 13 13 $4K
72125 Computed tomography, cervical spine; without contrast material 1,238 1,180 $4K
93970 24 24 $4K
J3490 Unclassified drugs 5,693 3,753 $4K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 540 533 $4K
J2405 Injection, ondansetron hydrochloride, per 1 mg 11,154 9,452 $3K
97161 1,036 951 $3K
82247 420 243 $3K
84484 8,468 6,661 $3K
85027 4,643 4,129 $3K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 399 346 $3K
73140 41 40 $3K
93976 1,385 1,288 $3K
82962 29 22 $3K
76642 77 66 $3K
86900 3,036 2,780 $3K
70496 30 29 $3K
83735 7,790 5,576 $2K
J0696 Injection, ceftriaxone sodium, per 250 mg 3,096 2,337 $2K
85007 803 687 $2K
J1815 Injection, insulin, per 5 units 2,202 757 $2K
81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants 92 80 $2K
72040 37 36 $2K
12002 26 26 $2K
82570 986 835 $2K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 161 160 $2K
97165 170 158 $2K
84439 1,274 1,226 $2K
83880 2,631 2,322 $2K
86803 1,555 1,499 $2K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 16 15 $2K
86780 910 851 $2K
86762 1,009 919 $2K
92523 12 12 $2K
82105 29 29 $2K
J2270 Injection, morphine sulfate, up to 10 mg 3,342 2,721 $2K
J1644 Injection, heparin sodium, per 1000 units 1,069 409 $2K
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 921 860 $1K
86140 2,543 2,268 $1K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,254 1,228 $1K
73660 12 12 $1K
85610 3,638 3,183 $1K
83036 Hemoglobin; glycosylated (A1C) 2,763 2,604 $1K
82803 1,019 890 $1K
12011 15 15 $1K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 12 12 $1K
97116 414 207 $1K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 5,510 5,183 $1K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 40 38 $1K
82140 31 28 $1K
J2175 Injection, meperidine hydrochloride, per 100 mg 1,115 944 $1K
J1170 Injection, hydromorphone, up to 4 mg 4,220 3,359 $997.58
70498 41 40 $951.78
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 1,199 1,016 $887.25
93922 13 12 $884.51
87040 2,513 2,224 $833.22
76775 24 24 $783.47
86901 3,037 2,781 $773.41
J1885 Injection, ketorolac tromethamine, per 15 mg 8,805 7,829 $766.80
J1790 Injection, droperidol, up to 5 mg 106 97 $764.44
97535 Self-care/home management training, each 15 minutes 453 252 $743.96
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 869 617 $738.47
J2250 Injection, midazolam hydrochloride, per 1 mg 3,253 3,072 $725.02
80143 914 853 $685.83
87045 29 27 $653.39
A4300 Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access 12 12 $536.44
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 27 25 $495.56
82607 309 303 $458.00
86592 365 327 $455.55
90715 687 678 $442.11
83540 142 140 $435.85
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 483 461 $419.67
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 59 53 $396.86
J3370 Injection, vancomycin hcl, 500 mg 179 86 $363.82
J3480 Injection, potassium chloride, per 2 meq 195 132 $363.45
J1940 Injection, furosemide, up to 20 mg 49 25 $356.46
90686 30 26 $356.46
97162 26 26 $353.55
73590 27 26 $289.18
82150 161 158 $253.17
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 1,835 1,761 $230.08
82728 176 162 $228.60
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 4,796 3,745 $215.30
85379 2,373 2,215 $183.38
82947 119 118 $166.21
87340 1,174 1,079 $159.27
86787 987 911 $158.66
83690 9,590 8,515 $157.62
83605 3,499 3,054 $148.76
82550 1,500 1,326 $128.14
84156 544 451 $106.80
82077 1,746 1,584 $103.81
62323 41 38 $99.40
A9585 Injection, gadobutrol, 0.1 ml 789 547 $94.29
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed 13 12 $91.45
87186 3,063 2,924 $64.19
G0463 Hospital outpatient clinic visit for assessment and management of a patient 24 18 $50.21
84550 422 348 $49.48
85730 2,387 2,081 $40.13
J0690 Injection, cefazolin sodium, 500 mg 2,657 2,218 $38.38
85014 2,081 1,952 $30.97
84145 750 665 $28.76
80179 742 698 $23.49
J0780 Injection, prochlorperazine, up to 10 mg 354 329 $23.33
J3010 Injection, fentanyl citrate, 0.1 mg 3,175 2,999 $20.41
83655 14 13 $15.61
J0131 Injection, acetaminophen, not otherwise specified,10 mg 503 458 $14.39
J0330 Injection, succinylcholine chloride, up to 20 mg 601 578 $10.10
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,302 1,189 $6.32
85652 925 862 $4.90
85651 993 886 $3.65
85018 292 222 $2.49
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 2,108 1,513 $1.51
J2765 Injection, metoclopramide hcl, up to 10 mg 432 386 $1.20
J2060 Injection, lorazepam, 2 mg 560 469 $0.35
J3475 Injection, magnesium sulfate, per 500 mg 1,009 814 $0.00
82248 471 281 $0.00
84100 428 352 $0.00
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg 95 67 $0.00
96367 408 317 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 78 77 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 61 60 $0.00
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 197 185 $0.00
97168 154 148 $0.00
76942 84 82 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 44 31 $0.00
J1171 Injection, hydromorphone, 0.1 mg 84 60 $0.00
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 29 29 $0.00
87075 41 38 $0.00
84466 38 38 $0.00
86336 16 16 $0.00
J7510 Prednisolone oral, per 5 mg 42 41 $0.00
76000 26 26 $0.00
93308 29 26 $0.00
51701 59 55 $0.00
82010 42 38 $0.00
86308 103 101 $0.00
J2795 Injection, ropivacaine hydrochloride, 1 mg 780 650 $0.00
J2785 Injection, regadenoson, 0.1 mg 85 81 $0.00
83615 294 240 $0.00
A9500 Technetium tc-99m sestamibi, diagnostic, per study dose 82 68 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 65 64 $0.00
86580 33 26 $0.00
87205 291 269 $0.00
J8540 Dexamethasone, oral, 0.25 mg 28 24 $0.00
J1040 Injection, methylprednisolone acetate, 80 mg 30 27 $0.00
45380 Colonoscopy, flexible; with biopsy, single or multiple 12 12 $0.00
82677 16 16 $0.00
P9612 Catheterization for collection of specimen, single patient, all places of service 152 129 $0.00
82746 52 52 $0.00
88300 12 12 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 25 25 $0.00