Medicaid Provider Spending

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

PRISMA HEALTH-UPSTATE

NPI: 1407301211 · GREENVILLE, SC 29605 · General Acute Care Hospital · NPI assigned 08/22/2016

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

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

$21.98M
Total Medicaid Paid
567,615
Total Claims
487,966
Beneficiaries
102
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMILLER, POLLY (VP PAYOR STRATEGIES & ALIGNMENT)
NPI Enumeration Date08/22/2016

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 $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
PRISMA HEALTH-UPSTATE SENECA SC $4.48M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 91,710 $3.57M
2019 95,734 $3.61M
2020 89,041 $3.47M
2021 91,391 $3.48M
2022 73,997 $3.06M
2023 70,216 $2.82M
2024 55,526 $1.98M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
36415 Collection of venous blood by venipuncture 43,809 36,776 $8.24M
81025 7,764 7,425 $2.58M
81003 64,024 40,151 $2.36M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 59,804 46,679 $2.01M
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 18,761 18,134 $1.53M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 9,506 8,791 $1.02M
87210 5,940 5,010 $611K
87086 Culture, bacterial; quantitative colony count, urine 17,996 16,412 $552K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 5,052 4,898 $479K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 43,533 30,936 $478K
82962 7,033 4,400 $326K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,608 1,573 $309K
87077 4,560 4,310 $204K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 6,152 5,806 $162K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1,890 1,787 $155K
82570 5,274 4,655 $145K
G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision 9,537 9,182 $135K
59025 Fetal non-stress test 7,482 4,196 $134K
87081 6,193 6,077 $100K
58301 563 536 $99K
11982 273 248 $95K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 978 941 $60K
58300 562 545 $43K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 17,711 17,116 $37K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 2,500 2,446 $26K
86850 9,245 8,842 $12K
80053 Comprehensive metabolic panel 7,324 6,393 $8K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 57 57 $6K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 18,411 17,764 $5K
83036 Hemoglobin; glycosylated (A1C) 4,556 4,398 $5K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 8,015 7,703 $5K
82950 9,151 8,934 $4K
90715 5,671 5,555 $4K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 116 113 $4K
83986 36 36 $3K
0012A 243 235 $3K
84156 5,460 4,745 $3K
Q3014 Telehealth originating site facility fee 113 104 $2K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 45 37 $2K
J1050 Injection, medroxyprogesterone acetate, 1 mg 7,253 7,136 $2K
J7307 Etonogestrel (contraceptive) implant system, including implant and supplies 166 160 $2K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 137 137 $2K
85027 16,835 15,546 $2K
84702 1,495 993 $1K
87529 12 12 $1K
90686 3,536 3,455 $1K
86780 15,825 15,398 $1K
0011A 296 286 $1K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 16,359 15,794 $1K
90678 201 195 $1K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 214 207 $1K
84443 Thyroid stimulating hormone (TSH) 3,264 3,145 $959.15
90651 398 384 $855.56
99215 Prolong outpt/office vis 1,085 1,054 $739.29
H0004 Behavioral health counseling and therapy, per 15 minutes 3,284 2,952 $723.83
86900 8,136 7,828 $545.28
83020 4,603 4,435 $490.20
86803 9,281 8,995 $462.80
82947 831 791 $397.28
86901 8,122 7,817 $344.15
85018 131 130 $316.80
86592 2,880 2,753 $287.82
H0002 Behavioral health screening to determine eligibility for admission to treatment program 5,671 5,479 $175.09
82951 719 703 $93.21
0064A 51 51 $34.09
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 442 427 $0.00
83615 1,408 1,276 $0.00
57454 130 129 $0.00
86762 7,711 7,432 $0.00
87340 8,134 7,850 $0.00
82728 225 217 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 8,324 7,978 $0.00
86870 83 81 $0.00
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 55 53 $0.00
J2791 Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu 226 220 $0.00
86317 254 242 $0.00
90656 215 212 $0.00
86704 254 242 $0.00
J7298 Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg 63 56 $0.00
88141 16 16 $0.00
82105 257 252 $0.00
82952 247 242 $0.00
87522 Neg quan hep c or qual rna 67 67 $0.00
J2790 Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) 13 13 $0.00
J0696 Injection, ceftriaxone sodium, per 250 mg 42 42 $0.00
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 30 30 $0.00
87536 17 17 $0.00
G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision 16 13 $0.00
86787 6,409 6,193 $0.00
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 42 42 $0.00
84550 1,593 1,438 $0.00
83540 188 178 $0.00
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 58 58 $0.00
87186 2,250 2,098 $0.00
84466 201 190 $0.00
85007 197 193 $0.00
90460 Immunization administration through 18 years of age via any route, first or only component 143 133 $0.00
90472 Immunization administration, each additional vaccine (list separately) 340 330 $0.00
84146 118 116 $0.00
J7297 Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg 84 82 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 18 14 $0.00
11981 12 12 $0.00