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PRISMA HEALTH MEDICAL GROUP-MIDLANDS

Clinic/Center, Multi-Specialty·COLUMBIA, SC·NPI: 1275988321Share

Compared to Clinic/Center, Multi-Specialty Peers

Total spending distribution among 12 providers in this specialty

P25MedianP75P90

This provider's total spending of $77.8M is at the 25th percentile among 12 Clinic/Center, Multi-Specialty providers.

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

Total Paid

$77.8M

$77,817,352

Total Claims

1.1M

Beneficiaries

991K

1.1 claims/patient

Avg Cost/Claim

$69

Monthly Spending Trend

Yearly Spending

2018
$8.6M
+8%
2019
$9.3M
+3%
2020
$9.5M
+15%
2021
$10.9M
+25%
2022
$13.7M
-2%
2023
$13.4M
-7%
2024
$12.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 18% of total spending.

99214Normal range

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

$14.3M

203K claims · 18.4%

Your Cost: $70.50/claim|Median: $53.41
1.3× median
99213Normal range

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

$9.6M

199K claims · 12.4%

Your Cost: $48.44/claim|Median: $37.81
1.3× median
90378Top 25%

$6.7M

2,243 claims · 8.5%

Your Cost: $2,965.74/claim|Median: $1,627.19
1.8× median
99284Normal range

Emergency dept visit, high complexity

$5.6M

65K claims · 7.2%

Your Cost: $86.32/claim|Median: $69.51
1.2× median
99285Normal range

Emergency dept visit, high/urgent complexity

$3.2M

27K claims · 4.2%

Your Cost: $120.51/claim|Median: $85.65
1.4× median
99283Normal range

Emergency dept visit, moderate complexity

$2.9M

58K claims · 3.7%

Your Cost: $49.04/claim|Median: $42.48
1.2× median
99244Top 25%

Office or other outpatient consultation, moderate complexity

$2.7M

18K claims · 3.5%

Your Cost: $149.81/claim|Median: $121.58
1.2× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$2.7M

54K claims · 3.4%

Your Cost: $49.30/claim|Median: $23.99
2.1× median
99215Normal range

Office/outpatient visit, high complexity

$2.1M

19K claims · 2.7%

Your Cost: $106.94/claim|Median: $74.09
1.4× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$1.9M

16K claims · 2.5%

Your Cost: $121.23/claim|Median: $54.68
2.2× median
76816Top 25%

Ultrasound, pregnant uterus, follow-up

$1.7M

20K claims · 2.2%

Your Cost: $84.71/claim|Median: $58.55
1.4× median
99204Top 25%

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

$1.3M

10K claims · 1.6%

Your Cost: $122.27/claim|Median: $84.03
1.5× median
14040Normal range

$1.2M

3,336 claims · 1.5%

Your Cost: $348.26/claim|Median: $311.85
1.1× median
95816Top 25%

$1.1M

4,551 claims · 1.5%

Your Cost: $251.22/claim|Median: $56.87
4.4× median
76811Top 25%

Ultrasound, pregnant uterus, detailed, single fetus

$1.1M

7,377 claims · 1.4%

Your Cost: $150.52/claim|Median: $106.79
1.4× median
54360Normal range

$1.0M

1,683 claims · 1.3%

Your Cost: $609.69/claim|Median: $609.21
1.0× median
93304Top 25%

$997K

8,303 claims · 1.3%

Your Cost: $120.12/claim|Median: $54.29
2.2× median
59409Top 10%

Vaginal delivery only

$883K

794 claims · 1.1%

Your Cost: $1,111.51/claim|Median: $619.91
1.8× median
99243Top 25%

Office or other outpatient consultation, low complexity

$861K

7,868 claims · 1.1%

Your Cost: $109.41/claim|Median: $82.43
1.3× median
99222Top 10%

Initial hospital care, per day, moderate complexity

$541K

5,005 claims · 0.7%

Your Cost: $108.03/claim|Median: $51.25
2.1× median
99231Top 25%

Subsequent hospital care, per day, low complexity

$533K

19K claims · 0.7%

Your Cost: $28.25/claim|Median: $16.77
1.7× median
93308Normal range

$526K

8,287 claims · 0.7%

Your Cost: $63.41/claim|Median: $20.08
3.2× median
76818Normal range

$511K

5,707 claims · 0.7%

Your Cost: $89.50/claim|Median: $68.15
1.3× median
95720Normal range

$509K

3,637 claims · 0.7%

Your Cost: $140.07/claim|Median: $120.95
1.2× median
99238Top 25%

Hospital discharge day management, 30 minutes or less

$479K

7,925 claims · 0.6%

Your Cost: $60.48/claim|Median: $37.22
1.6× median
92014Top 25%

Ophthalmological exam, comprehensive, established patient

$459K

5,954 claims · 0.6%

Your Cost: $77.05/claim|Median: $47.08
1.6× median
95165Normal range

Professional services for allergen immunotherapy, per injection

$451K

2,123 claims · 0.6%

Your Cost: $212.53/claim|Median: $144.04
1.5× median
95951Normal range

$439K

2,055 claims · 0.6%

Your Cost: $213.65/claim|Median: $183.28
1.2× median
99223Top 10%

Initial hospital care, per day, high complexity

$422K

3,151 claims · 0.5%

Your Cost: $134.08/claim|Median: $67.32
2.0× median
76819Normal range

Fetal biophysical profile with non-stress test

$408K

6,298 claims · 0.5%

Your Cost: $64.76/claim|Median: $49.45
1.3× median
99233Top 25%

Subsequent hospital care, per day, high complexity

$401K

5,564 claims · 0.5%

Your Cost: $72.07/claim|Median: $35.30
2.0× median
93325Normal range

$373K

19K claims · 0.5%

Your Cost: $20.06/claim|Median: $14.61
1.4× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$358K

492 claims · 0.5%

Your Cost: $726.66/claim|Median: $470.36
1.5× median
99212Normal range

Office/outpatient visit, low complexity

$348K

12K claims · 0.4%

Your Cost: $29.42/claim|Median: $25.06
1.2× median
99219Top 10%

$342K

3,123 claims · 0.4%

Your Cost: $109.46/claim|Median: $63.35
1.7× median
93321Normal range

$331K

17K claims · 0.4%

Your Cost: $19.94/claim|Median: $9.69
2.1× median
99291Top 25%

Critical care, first 30-74 minutes

$323K

2,029 claims · 0.4%

Your Cost: $159.07/claim|Median: $101.24
1.6× median
43239Normal range

Upper GI endoscopy with biopsy

$312K

3,174 claims · 0.4%

Your Cost: $98.45/claim|Median: $151.68
0.6× median
92004Top 25%

Ophthalmological exam, comprehensive, new patient

$306K

3,110 claims · 0.4%

Your Cost: $98.27/claim|Median: $59.72
1.6× median
95810Normal range

Polysomnography, sleep study, 6+ hours

$300K

2,793 claims · 0.4%

Your Cost: $107.55/claim|Median: $233.73
0.5× median
94010Normal range

$300K

14K claims · 0.4%

Your Cost: $22.19/claim|Median: $18.11
1.2× median
99203Top 25%

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

$286K

3,644 claims · 0.4%

Your Cost: $78.42/claim|Median: $57.85
1.4× median
76805Top 25%

Ultrasound, pregnant uterus, complete, single fetus

$272K

2,593 claims · 0.3%

Your Cost: $104.87/claim|Median: $74.78
1.4× median
95819Top 25%

Electroencephalogram with sleep recording

$272K

931 claims · 0.3%

Your Cost: $292.00/claim|Median: $62.75
4.7× median
99392Normal range

Preventive medicine, established patient, age 1-4

$263K

3,843 claims · 0.3%

Your Cost: $68.34/claim|Median: $75.18
0.9× median
92015Normal range

Determination of refractive state

$261K

16K claims · 0.3%

Your Cost: $15.84/claim|Median: $10.36
1.5× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$249K

4,032 claims · 0.3%

Your Cost: $61.78/claim|Median: $69.35
0.9× median
99393Normal range

Preventive medicine, established patient, age 5-11

$249K

3,670 claims · 0.3%

Your Cost: $67.83/claim|Median: $74.82
0.9× median
99245Top 25%

Office consultation, high complexity

$247K

1,366 claims · 0.3%

Your Cost: $180.98/claim|Median: $143.30
1.3× median
92060Normal range

$244K

5,828 claims · 0.3%

Your Cost: $41.84/claim|Median: $35.83
1.2× median

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