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Prisma Health University Medical Group

Internal Medicine·Greenville, SC·NPI: 1295763217Share

Compared to Internal Medicine Peers

Total spending distribution among 26 providers in this specialty

P25MedianP75P90

This provider's total spending of $172.2M is at the 75th percentile among 26 Internal Medicine providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$172.2M

$172,150,510

Total Claims

3.0M

Beneficiaries

2.8M

1.1 claims/patient

Avg Cost/Claim

$57

#568 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Prisma Health University Medical Group is a Internal Medicine provider based in Greenville, SC. From the 2018–2024 period, this provider received $172.2M in Medicaid payments across 3.0M claims.

Why This Matters

This provider received $172.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,518 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 7% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$22.9M
-0%
2019
$22.8M
-7%
2020
$21.3M
+19%
2021
$25.4M
+9%
2022
$27.7M
-0%
2023
$27.6M
-11%
2024
$24.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 22% of total spending.

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$37.2M

522K claims · 21.6%

Your Cost: $71.30/claim|Median: $53.41
1.3× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$33.9M

672K claims · 19.7%

Your Cost: $50.37/claim|Median: $37.81
1.3× median
99284Normal range

Emergency dept visit, high complexity

$14.8M

181K claims · 8.6%

Your Cost: $81.74/claim|Median: $69.51
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$7.1M

69K claims · 4.1%

Your Cost: $102.91/claim|Median: $74.09
1.4× median
59409Top 10%

Vaginal delivery only

$6.9M

6K claims · 4.0%

Your Cost: $1,079.82/claim|Median: $619.91
1.7× median
99285Normal range

Emergency dept visit, high/urgent complexity

$6.6M

59K claims · 3.9%

Your Cost: $112.07/claim|Median: $85.65
1.3× median
99283Normal range

Emergency dept visit, moderate complexity

$5.9M

130K claims · 3.4%

Your Cost: $45.37/claim|Median: $42.48
1.1× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$5.4M

75K claims · 3.1%

Your Cost: $71.72/claim|Median: $69.35
1.0× median
99392Normal range

Preventive medicine, established patient, age 1-4

$5.1M

65K claims · 3.0%

Your Cost: $78.10/claim|Median: $75.18
1.0× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$4.0M

140K claims · 2.3%

Your Cost: $28.33/claim|Median: $17.85
1.6× median
99244Top 25%

Office or other outpatient consultation, moderate complexity

$3.6M

23K claims · 2.1%

Your Cost: $157.72/claim|Median: $121.58
1.3× median
76816Top 25%

Ultrasound, pregnant uterus, follow-up

$2.7M

31K claims · 1.6%

Your Cost: $88.34/claim|Median: $58.55
1.5× median
99393Normal range

Preventive medicine, established patient, age 5-11

$2.5M

32K claims · 1.5%

Your Cost: $77.16/claim|Median: $74.82
1.0× median
G9153Normal range

$2.2M

41K claims · 1.3%

Your Cost: $53.73/claim|Median: $43.70
1.2× median
76811Top 25%

Ultrasound, pregnant uterus, detailed, single fetus

$1.9M

13K claims · 1.1%

Your Cost: $149.58/claim|Median: $106.79
1.4× median
76819Normal range

Fetal biophysical profile with non-stress test

$1.8M

27K claims · 1.1%

Your Cost: $68.09/claim|Median: $49.45
1.4× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$1.6M

18K claims · 0.9%

Your Cost: $90.99/claim|Median: $54.68
1.7× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$1.6M

21K claims · 0.9%

Your Cost: $76.22/claim|Median: $57.85
1.3× median
99243Top 25%

Office or other outpatient consultation, low complexity

$1.5M

14K claims · 0.9%

Your Cost: $106.24/claim|Median: $82.43
1.3× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$1.5M

33K claims · 0.9%

Your Cost: $45.40/claim|Median: $23.99
1.9× median
93303Normal range

Echocardiography, transthoracic, limited

$1.3M

9K claims · 0.8%

Your Cost: $154.47/claim|Median: $112.83
1.4× median
95812Top 25%

$1.3M

6K claims · 0.8%

Your Cost: $220.16/claim|Median: $104.99
2.1× median
59514Top 10%

Cesarean delivery only

$1.1M

1K claims · 0.6%

Your Cost: $957.58/claim|Median: $452.80
2.1× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$1.0M

9K claims · 0.6%

Your Cost: $115.54/claim|Median: $84.03
1.4× median
90461Normal range

Immunization admin, additional vaccine, counseling

$863K

42K claims · 0.5%

Your Cost: $20.51/claim|Median: $6.93
3.0× median
87428Top 25%

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$812K

13K claims · 0.5%

Your Cost: $61.89/claim|Median: $39.63
1.6× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$771K

13K claims · 0.4%

Your Cost: $59.02/claim|Median: $37.22
1.6× median
99394Normal range

Preventive medicine, established patient, age 12-17

$760K

9K claims · 0.4%

Your Cost: $83.51/claim|Median: $80.15
1.0× median
76817Top 25%

Ultrasound, pregnant uterus, transvaginal

$582K

7K claims · 0.3%

Your Cost: $79.65/claim|Median: $47.65
1.7× median
76820Normal range

$536K

14K claims · 0.3%

Your Cost: $37.59/claim|Median: $31.79
1.2× median

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