Medicaid Provider Spending

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

NPI: 1437605532 · GREENVILLE, SC 29605 · 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

$25.04M
Total Medicaid Paid
474,333
Total Claims
449,779
Beneficiaries
127
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMILLER, POLLY (SVP FINANCE, ENTERPRISE CONTRACTING)
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 $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
PRISMA HEALTH-UPSTATE SENECA SC $4.48M

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 75,903 $3.82M
2019 73,242 $3.85M
2020 68,145 $3.58M
2021 86,600 $4.79M
2022 70,457 $3.76M
2023 70,162 $3.72M
2024 29,824 $1.51M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 48,880 44,272 $3.70M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 31,458 28,366 $2.79M
94760 27,124 24,593 $2.35M
36415 Collection of venous blood by venipuncture 14,148 13,226 $2.18M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 20,806 19,467 $1.92M
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,784 1,432 $1.55M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 22,183 20,093 $1.06M
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 6,297 6,123 $1.04M
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 931 589 $1.02M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 13,097 12,946 $842K
99188 11,784 11,578 $812K
83655 7,322 7,158 $811K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 17,321 17,047 $675K
99215 Prolong outpt/office vis 4,086 3,388 $592K
96110 Developmental screening, with scoring and documentation, per standardized instrument 5,819 5,754 $528K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 8,106 8,024 $461K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 4,514 3,385 $255K
87070 1,421 1,404 $173K
81003 3,255 3,111 $156K
85018 8,311 8,171 $151K
80053 Comprehensive metabolic panel 5,292 4,962 $144K
96127 1,395 1,377 $140K
94664 1,822 1,744 $124K
82247 1,211 772 $119K
0202U Oncology (prostate), multianalyte, gene expression profiling 682 560 $119K
87086 Culture, bacterial; quantitative colony count, urine 1,597 1,530 $116K
99174 1,020 1,011 $109K
81025 949 916 $105K
96161 1,045 1,013 $100K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,262 1,222 $92K
87081 1,096 1,067 $92K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 3,293 3,235 $80K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance 121 107 $79K
87077 814 781 $58K
90686 19,321 19,084 $38K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 491 474 $37K
94010 228 228 $34K
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 4,208 4,062 $26K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 677 669 $24K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 1,977 1,937 $23K
94761 985 899 $21K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 156 153 $20K
96160 1,468 1,449 $20K
90460 Immunization administration through 18 years of age via any route, first or only component 42,236 41,496 $17K
85007 848 778 $17K
85027 1,938 1,765 $15K
80061 Lipid panel 5,808 5,692 $14K
90461 11,771 11,648 $14K
81001 866 812 $13K
G0463 Hospital outpatient clinic visit for assessment and management of a patient 245 203 $13K
69210 83 79 $13K
88720 73 64 $10K
99177 71 64 $9K
17250 14 13 $8K
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 1,419 1,367 $7K
0072A 202 201 $7K
84443 Thyroid stimulating hormone (TSH) 1,276 1,234 $6K
99173 70 70 $6K
90633 8,012 7,821 $6K
69209 39 39 $6K
0002A 141 141 $5K
90670 14,574 14,323 $5K
96375 Therapeutic injection; each additional sequential IV push 13 13 $4K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 2,550 2,379 $4K
0001A 183 180 $4K
83036 Hemoglobin; glycosylated (A1C) 3,263 3,205 $4K
87486 13 13 $3K
0071A 327 323 $3K
90696 3,470 3,401 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 432 397 $2K
90651 4,805 4,744 $2K
90715 2,956 2,923 $2K
0052A 59 59 $1K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 25 25 $1K
86140 960 911 $1K
90677 1,350 1,303 $1K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 96 96 $1K
99382 30 30 $1K
90378 365 254 $1K
90698 7,618 7,443 $983.73
94060 15 15 $970.50
90621 967 950 $787.89
0081A 159 157 $787.80
90619 1,362 1,347 $663.97
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 12 12 $613.46
0082A 24 24 $511.19
90656 248 247 $501.35
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 895 881 $434.51
90707 3,998 3,928 $421.90
86592 66 66 $389.00
84439 42 38 $343.29
90716 3,991 3,920 $326.43
90647 2,596 2,556 $318.34
82784 327 304 $293.77
J1100 Injection, dexamethasone sodium phosphate, 1 mg 599 510 $229.75
90710 3,344 3,282 $215.86
0051A 52 52 $173.24
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 612 603 $170.01
90680 8,823 8,653 $156.90
86780 82 81 $150.06
87807 17 17 $142.04
82248 1,304 859 $133.69
90744 4,554 4,467 $114.97
90620 289 284 $68.91
91320 13 12 $38.24
90697 3,391 3,332 $20.17
90734 2,850 2,816 $0.02
90700 771 765 $0.02
87186 250 237 $0.00
90648 13 13 $0.00
J1050 Injection, medroxyprogesterone acetate, 1 mg 13 13 $0.00
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 12 12 $0.00
J1745 Injection, infliximab, excludes biosimilar, 10 mg 83 45 $0.00
87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets 13 13 $0.00
84460 12 12 $0.00
84450 12 12 $0.00
85651 673 655 $0.00
90723 2,731 2,692 $0.00
86308 13 13 $0.00
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 219 141 $0.00
85652 624 582 $0.00
J1459 Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg 37 24 $0.00
96415 121 107 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 21 21 $0.00
90480 58 56 $0.00
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 54 52 $0.00
87581 13 13 $0.00