Medicaid Provider Spending

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

PRISMA HEALTH-UPSTATE

NPI: 1447706569 · SIMPSONVILLE, SC 29681 · 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

$8.30M
Total Medicaid Paid
376,262
Total Claims
339,765
Beneficiaries
203
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 40,003 $875K
2019 46,304 $882K
2020 39,584 $855K
2021 55,613 $1.30M
2022 66,746 $1.63M
2023 67,813 $1.59M
2024 60,199 $1.17M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
80053 Comprehensive metabolic panel 15,514 13,916 $1.01M
36415 Collection of venous blood by venipuncture 10,019 8,343 $676K
99283 Emergency department visit for the evaluation and management, moderate severity 18,371 17,554 $577K
99282 Emergency department visit for the evaluation and management, low to moderate severity 4,907 4,769 $472K
80048 Basic metabolic panel (calcium, ionized) 7,635 6,730 $419K
87081 5,397 5,316 $327K
81025 9,388 8,926 $322K
86850 1,778 1,630 $303K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 3,111 2,616 $273K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 3,175 3,048 $242K
96361 Intravenous infusion, hydration; each additional hour 6,741 5,591 $212K
76830 Ultrasound, transvaginal 1,538 1,497 $169K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 7,322 6,628 $161K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1,267 1,242 $153K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 5,339 3,680 $150K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 3,482 2,828 $146K
87086 Culture, bacterial; quantitative colony count, urine 7,136 6,722 $124K
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 2,928 2,789 $107K
74177 Computed tomography, abdomen and pelvis; with contrast material 3,355 3,216 $106K
88305 Level IV - Surgical pathology, gross and microscopic examination 1,410 1,383 $105K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 4,788 4,567 $92K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation 795 760 $92K
71046 Radiologic examination, chest; 2 views 5,017 4,845 $88K
87210 3,199 2,590 $81K
87077 2,749 2,642 $77K
99284 Emergency department visit for the evaluation and management, high severity 10,830 10,243 $77K
87428 1,308 1,274 $77K
81001 10,604 9,903 $73K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 2,039 1,848 $70K
70450 Computed tomography, head or brain; without contrast material 2,433 2,336 $66K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 1,044 1,003 $65K
74176 Computed tomography, abdomen and pelvis; without contrast material 1,100 1,068 $61K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 2,270 2,098 $59K
81003 4,899 4,689 $56K
99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life 10,323 9,581 $50K
87400 642 620 $48K
73610 1,034 1,002 $46K
73130 473 458 $43K
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 474 448 $41K
76705 Ultrasound, abdominal, real time with image documentation; limited 945 921 $40K
85610 2,690 2,150 $40K
86900 1,965 1,788 $39K
73630 1,003 970 $36K
86780 2,431 2,267 $35K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 625 606 $35K
82565 222 202 $34K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies 2,219 2,076 $34K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences 37 37 $30K
84702 1,726 1,474 $30K
71045 Radiologic examination, chest; single view 4,557 4,220 $30K
71250 148 147 $29K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 1,204 1,173 $28K
82950 1,288 1,257 $27K
73564 784 752 $25K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 23,347 20,346 $24K
77063 Screening digital breast tomosynthesis, bilateral 242 242 $24K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 637 618 $24K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 4,401 4,302 $24K
99281 Emergency department visit for the evaluation and management, self-limited or minor 198 191 $20K
71275 Computed tomographic angiography, chest, with contrast material 499 486 $20K
73110 195 192 $19K
74018 594 566 $19K
59025 Fetal non-stress test 453 309 $19K
87070 262 254 $18K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material 27 27 $17K
83655 907 898 $17K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 8,638 7,614 $14K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 321 308 $14K
J7120 Ringers lactate infusion, up to 1000 cc 5,117 4,530 $14K
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types 581 554 $11K
84443 Thyroid stimulating hormone (TSH) 3,802 3,643 $11K
73030 367 354 $10K
96375 Therapeutic injection; each additional sequential IV push 5,318 4,472 $9K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 664 632 $9K
72100 336 330 $8K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 1,353 1,334 $7K
83036 Hemoglobin; glycosylated (A1C) 2,237 2,090 $6K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B 54 53 $6K
76801 537 484 $6K
71260 Computed tomography, thorax, diagnostic; with contrast material 26 26 $6K
93017 106 105 $6K
76819 Fetal biophysical profile; without non-stress testing 71 48 $5K
80076 1,209 1,118 $5K
G0378 Hospital observation service, per hour 1,505 1,232 $5K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 69 69 $5K
85027 3,475 3,217 $4K
80061 Lipid panel 1,766 1,720 $4K
83001 106 101 $4K
85018 1,526 1,497 $4K
77067 Screening mammography, bilateral, including computer-aided detection 424 422 $4K
84484 4,804 4,061 $4K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 206 189 $4K
0202U Oncology (prostate), multianalyte, gene expression profiling 29 29 $3K
88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer 111 109 $3K
82728 223 220 $2K
96376 1,921 1,371 $2K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour 529 338 $2K
80047 115 109 $2K
83986 30 30 $2K
87807 301 299 $2K
83690 5,746 5,206 $2K
85379 1,478 1,409 $2K
85007 537 503 $2K
82105 126 115 $2K
J2270 Injection, morphine sulfate, up to 10 mg 1,885 1,606 $2K
86762 1,177 1,063 $2K
83540 278 269 $2K
82570 549 487 $2K
86803 1,179 1,107 $1K
82247 112 68 $1K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 1,583 1,357 $1K
83735 3,857 3,102 $1K
84439 256 243 $1K
G0472 Hepatitis c antibody screening, for individual at high risk and other covered indication(s) 165 134 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 67 66 $1K
J1170 Injection, hydromorphone, up to 4 mg 2,082 1,569 $1K
84146 56 54 $1K
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe 2,546 2,376 $1K
72040 27 26 $1K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 269 265 $980.92
J2405 Injection, ondansetron hydrochloride, per 1 mg 5,558 4,780 $931.63
74022 56 54 $929.06
93976 715 688 $884.75
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml 5,280 5,038 $860.44
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 4,504 4,266 $830.95
72125 Computed tomography, cervical spine; without contrast material 170 162 $794.35
83605 1,908 1,685 $732.33
73502 37 37 $704.67
J1644 Injection, heparin sodium, per 1000 units 1,134 558 $704.64
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 834 769 $665.11
J3475 Injection, magnesium sulfate, per 500 mg 246 226 $652.84
76775 12 12 $600.30
82607 124 120 $579.41
J0690 Injection, cefazolin sodium, 500 mg 1,041 972 $560.13
J2795 Injection, ropivacaine hydrochloride, 1 mg 432 406 $528.21
86140 1,774 1,664 $509.64
83880 1,715 1,573 $426.05
J3490 Unclassified drugs 3,366 2,199 $418.90
J7030 Infusion, normal saline solution , 1000 cc 6,610 5,730 $393.25
A9585 Injection, gadobutrol, 0.1 ml 313 302 $371.14
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 55 52 $360.26
82077 514 485 $349.33
J2550 Injection, promethazine hcl, up to 50 mg 470 394 $341.89
88141 17 17 $331.98
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 524 370 $286.71
86787 749 697 $246.69
87177 29 25 $197.46
J0696 Injection, ceftriaxone sodium, per 250 mg 1,839 1,595 $193.26
86901 1,963 1,788 $159.93
J2250 Injection, midazolam hydrochloride, per 1 mg 1,368 1,249 $155.09
87340 1,394 1,270 $152.07
82550 28 25 $132.17
86308 13 13 $125.89
J0330 Injection, succinylcholine chloride, up to 20 mg 107 97 $102.71
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 46 24 $86.11
76000 12 12 $83.02
73090 17 17 $72.35
83020 186 154 $51.76
87040 426 383 $46.42
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 3,018 2,416 $46.20
86317 111 83 $37.48
84550 93 80 $32.04
J1100 Injection, dexamethasone sodium phosphate, 1 mg 2,303 2,154 $27.49
J1885 Injection, ketorolac tromethamine, per 15 mg 4,701 4,361 $26.04
82784 17 12 $11.27
87186 1,802 1,719 $11.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 698 587 $7.96
J1200 Injection, diphenhydramine hcl, up to 50 mg 1,039 942 $5.97
84156 282 244 $4.73
85651 423 396 $4.71
84100 941 759 $0.00
C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) 25 25 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 130 125 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 80 63 $0.00
97163 25 24 $0.00
90715 58 57 $0.00
82248 176 111 $0.00
84145 161 146 $0.00
84466 263 254 $0.00
J2710 Injection, neostigmine methylsulfate, up to 0.5 mg 38 30 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 155 151 $0.00
80143 29 27 $0.00
97530 Therapeutic activities, direct patient contact, each 15 minutes 37 26 $0.00
94664 15 13 $0.00
86682 18 16 $0.00
J1650 Injection, enoxaparin sodium, 10 mg 128 60 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 40 39 $0.00
45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) 14 14 $0.00
87209 29 25 $0.00
73590 12 12 $0.00
80179 13 13 $0.00
85730 561 519 $0.00
J2765 Injection, metoclopramide hcl, up to 10 mg 636 573 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 224 206 $0.00
85652 551 515 $0.00
83615 76 65 $0.00
87205 172 165 $0.00
86704 109 81 $0.00
J1815 Injection, insulin, per 5 units 55 24 $0.00
J2360 Injection, orphenadrine citrate, up to 60 mg 24 24 $0.00
88304 13 12 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 30 30 $0.00
J2060 Injection, lorazepam, 2 mg 59 56 $0.00