Medicaid Provider Spending

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

PRISMA HEALTH-UPSTATE

NPI: 1245786367 · CLINTON, SC 29325 · 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

$13.11M
Total Medicaid Paid
575,112
Total Claims
488,375
Beneficiaries
196
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-UPSTATE SENECA SC $15.64M
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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 64,279 $1.53M
2019 82,452 $1.68M
2020 72,143 $1.51M
2021 94,752 $1.93M
2022 98,984 $2.30M
2023 94,962 $2.49M
2024 67,540 $1.69M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
36415 Collection of venous blood by venipuncture 19,028 13,744 $1.53M
80053 Comprehensive metabolic panel 24,304 21,418 $1.36M
99283 Emergency department visit for the evaluation and management, moderate severity 27,962 26,060 $1.13M
99282 Emergency department visit for the evaluation and management, low to moderate severity 6,504 6,303 $869K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 5,983 5,712 $555K
80048 Basic metabolic panel (calcium, ionized) 14,087 10,980 $537K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 13,093 8,192 $487K
81025 10,406 9,721 $382K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 10,644 6,861 $354K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 3,241 2,950 $337K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 778 364 $328K
96361 Intravenous infusion, hydration; each additional hour 8,715 6,745 $326K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 9,711 8,341 $281K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 7,914 2,037 $280K
81001 18,837 16,969 $255K
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 4,515 4,199 $196K
76830 Ultrasound, transvaginal 638 615 $188K
87070 1,183 1,091 $169K
87081 2,643 2,594 $166K
87086 Culture, bacterial; quantitative colony count, urine 10,712 9,919 $165K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 3,031 2,947 $162K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 738 701 $138K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 4,676 4,192 $131K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 12,881 12,321 $130K
99284 Emergency department visit for the evaluation and management, high severity 15,816 14,368 $127K
70450 Computed tomography, head or brain; without contrast material 3,695 3,409 $115K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 2,253 2,106 $107K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 3,727 3,224 $97K
87077 3,917 3,660 $91K
73630 1,674 1,542 $86K
85018 14,016 13,841 $82K
97597 2,027 839 $81K
73610 1,376 1,295 $78K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 3,521 3,375 $74K
71046 Radiologic examination, chest; 2 views 4,095 3,924 $73K
71045 Radiologic examination, chest; single view 8,503 7,530 $68K
74177 Computed tomography, abdomen and pelvis; with contrast material 3,203 3,018 $65K
81003 16,304 15,393 $58K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 2,764 2,471 $58K
73130 623 601 $57K
73564 1,465 1,369 $54K
71250 139 137 $52K
99281 Emergency department visit for the evaluation and management, self-limited or minor 402 385 $52K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 13,561 11,385 $49K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 34,836 27,994 $46K
80047 728 683 $44K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,134 1,063 $44K
76705 Ultrasound, abdominal, real time with image documentation; limited 838 793 $44K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 14,360 12,785 $44K
73030 1,014 965 $41K
87210 1,899 1,769 $40K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,077 1,048 $40K
86900 1,090 1,007 $39K
86850 550 508 $34K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 1,592 987 $32K
84702 1,667 1,464 $31K
73110 439 416 $30K
80061 Lipid panel 7,002 6,784 $29K
83036 Hemoglobin; glycosylated (A1C) 7,093 6,859 $28K
74018 805 728 $27K
87807 1,570 1,531 $26K
77063 Screening digital breast tomosynthesis, bilateral 234 233 $25K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 510 485 $23K
77067 Screening mammography, bilateral, including computer-aided detection 925 912 $20K
71260 Computed tomography, thorax, diagnostic; with contrast material 103 99 $20K
72100 826 788 $19K
71275 Computed tomographic angiography, chest, with contrast material 573 528 $18K
93971 65 63 $16K
84443 Thyroid stimulating hormone (TSH) 8,122 7,789 $15K
88305 Level IV - Surgical pathology, gross and microscopic examination 185 179 $14K
97162 1,018 959 $14K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 425 333 $14K
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 948 834 $13K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 89 88 $13K
97530 Therapeutic activities, direct patient contact, each 15 minutes 2,021 1,031 $13K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 814 598 $13K
96375 Therapeutic injection; each additional sequential IV push 7,747 6,107 $13K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 1,718 1,653 $12K
G0378 Hospital observation service, per hour 2,902 2,403 $12K
84439 1,687 1,616 $11K
97032 98 53 $11K
J7120 Ringers lactate infusion, up to 1000 cc 3,778 3,285 $10K
85027 4,075 3,671 $10K
86308 390 385 $10K
93017 63 60 $8K
82043 1,081 1,054 $8K
86780 187 175 $7K
82607 925 892 $7K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 590 570 $7K
J7030 Infusion, normal saline solution , 1000 cc 8,815 6,984 $6K
87428 87 85 $6K
80076 1,841 1,703 $6K
82565 59 54 $6K
J3490 Unclassified drugs 3,513 2,227 $5K
83690 6,802 5,927 $5K
J1815 Injection, insulin, per 5 units 2,133 862 $5K
84484 7,168 5,538 $5K
J1644 Injection, heparin sodium, per 1000 units 1,382 464 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 307 280 $4K
85610 3,453 2,948 $4K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 27 25 $4K
73502 147 142 $3K
74022 305 285 $3K
86803 831 804 $3K
12001 41 41 $3K
72125 Computed tomography, cervical spine; without contrast material 991 926 $3K
83540 979 937 $3K
82728 486 431 $3K
J2765 Injection, metoclopramide hcl, up to 10 mg 993 852 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 2,790 2,238 $3K
85007 1,140 966 $3K
82947 357 348 $3K
J2270 Injection, morphine sulfate, up to 10 mg 3,293 2,578 $3K
J2405 Injection, ondansetron hydrochloride, per 1 mg 6,679 5,598 $3K
85379 1,685 1,543 $3K
86580 205 180 $2K
73080 50 48 $2K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 3,362 3,206 $2K
86140 1,830 1,663 $2K
83880 2,560 2,116 $2K
73140 16 12 $2K
87400 25 21 $2K
J0696 Injection, ceftriaxone sodium, per 250 mg 2,756 2,199 $2K
82570 1,032 980 $2K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 778 292 $2K
83735 7,474 5,288 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg 7,062 6,281 $1K
J1650 Injection, enoxaparin sodium, 10 mg 1,422 589 $1K
96376 3,426 2,108 $1K
J3475 Injection, magnesium sulfate, per 500 mg 607 487 $1K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 5,147 4,640 $1K
84145 1,045 883 $926.49
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 13 13 $917.77
T1015 Clinic visit/encounter, all-inclusive 50 37 $897.69
85730 1,056 931 $809.47
93976 766 737 $762.84
80143 228 202 $703.32
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals 48 38 $661.69
82077 1,315 1,151 $654.33
82550 413 370 $625.79
73562 13 13 $511.80
82746 196 190 $498.47
82803 308 265 $480.96
84100 2,091 1,358 $465.35
76642 13 13 $437.73
82962 23 19 $423.28
76815 Ultrasound, pregnant uterus, real time with image documentation, limited 14 13 $420.18
59025 Fetal non-stress test 86 64 $407.94
86038 27 27 $398.89
J2550 Injection, promethazine hcl, up to 50 mg 1,307 1,003 $393.28
81002 435 427 $341.89
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 25 25 $258.11
73590 28 26 $253.02
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 1,190 1,130 $177.27
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 13 13 $163.20
97161 25 25 $152.54
97166 61 58 $147.68
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 3,710 2,672 $144.05
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 181 172 $111.75
83605 3,503 2,918 $92.39
87040 1,507 1,276 $87.50
86480 17 16 $82.29
84156 34 29 $49.34
87186 3,096 2,877 $47.17
90715 238 230 $40.37
70496 12 12 $31.95
80179 113 102 $13.42
84550 53 49 $6.88
J1170 Injection, hydromorphone, up to 4 mg 1,495 1,165 $6.53
85652 821 767 $6.38
87205 492 447 $4.46
J0690 Injection, cefazolin sodium, 500 mg 141 128 $4.09
J1100 Injection, dexamethasone sodium phosphate, 1 mg 2,155 2,009 $2.08
85651 490 448 $0.90
J1200 Injection, diphenhydramine hcl, up to 50 mg 937 819 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 963 834 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 274 261 $0.00
84466 631 599 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 80 76 $0.00
96367 130 92 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 49 38 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 229 169 $0.00
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 12 12 $0.00
J2300 Injection, nalbuphine hydrochloride, per 10 mg 134 122 $0.00
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 15 12 $0.00
86901 1,089 1,007 $0.00
J2060 Injection, lorazepam, 2 mg 386 288 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 471 422 $0.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 1,086 733 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 391 367 $0.00
A9585 Injection, gadobutrol, 0.1 ml 28 28 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 28 25 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 106 100 $0.00
J0500 Injection, dicyclomine hcl, up to 20 mg 12 12 $0.00
J3480 Injection, potassium chloride, per 2 meq 48 28 $0.00
70498 12 12 $0.00