Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Carolina only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Carolina (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Prisma Health University Medical Group (NPI 1528465374)

Field	Value
Entity Type	Organization
Organization	Prisma Health University Medical Group
Address	7 Independence Pt Ste 300
City	Greenville
State	SC
ZIP	29615
Taxonomy	Anesthesiology Physician
NPI Enumerated	November 21, 2014

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	3,220	$490	$1.6M
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	3,410	$90	$307.2K
00920	The provider performs anesthesia services for a patient undergoing a procedure on male genitalia that is not specified by any other anesthesia code. As part of the procedure, the provider may incise…	1,240	$70	$89.5K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	1,350	$60	$74K
00126	The provider performs anesthesia services for a patient undergoing procedures on the external, middle, and inner ear including biopsy and tympanotomy.	130	$50	$6.1K
00790	The provider performs anesthesia services for a patient undergoing intraperitoneal procedures in the upper abdomen, including laparoscopy, which are not specified by any other anesthesia code.	30	$150	$3.7K
01961	The provider performs anesthesia services for a cesarean delivery.	30	$150	$3.6K
00750	The provider performs anesthesia services for hernia repairs in upper abdomen, not otherwise specified.	30	$90	$2.4K
00813	The anesthesia provider performs anesthesia services for a patient undergoing both upper and lower intestinal endoscopy where the surgical provider introduces an endoscope into the intestines above…	30	$50	$1.5K
00400	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system on the extremities, anterior trunk and perineum, not otherwise specified.	20	$80	$1.2K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Carolina Distribution

Prisma Health University Medical Group — 1 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	1	30	250	$360	$227.9K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	4	40	350	$90	$105.5K
00920	The provider performs anesthesia services for a patient undergoing a procedure on male genitalia that is not specified by any other anesthesia code. As part of the procedure, the provider may incise…	2	10	130	$70	$30.3K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	3	30	80	$60	$21K
01961	The provider performs anesthesia services for a cesarean delivery.	12	20	40	$120	$10.2K
00126	The provider performs anesthesia services for a patient undergoing procedures on the external, middle, and inner ear including biopsy and tympanotomy.	5	20	60	$60	$8.7K
00813	The anesthesia provider performs anesthesia services for a patient undergoing both upper and lower intestinal endoscopy where the surgical provider introduces an endoscope into the intestines above…	6	10	30	$50	$6.6K
00750	The provider performs anesthesia services for hernia repairs in upper abdomen, not otherwise specified.	1	10	30	$90	$2.3K
00790	The provider performs anesthesia services for a patient undergoing intraperitoneal procedures in the upper abdomen, including laparoscopy, which are not specified by any other anesthesia code.	2	10	30	$50	$1.9K
00400	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system on the extremities, anterior trunk and perineum, not otherwise specified.	1	10	20	$80	$1.2K

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Prisma Health University Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health University Medical Group	SC	Family Medicine Physician	$0	$171.7M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$86.9M
Prisma Health Medical Group-midlands	SC	Multi-Specialty Clinic/Center	$0	$77.6M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$25M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$22M
Prisma Health-upstate	SC	Developmental Disabilities Clinic/Center	$0	$19.7M
Prisma Health University Medical Group	SC	Developmental - Behavioral Pediatrics Physician	$0	$16M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$15.6M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$13.1M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$10.9M

Nearby Providers

Other providers in the same ZIP code as Prisma Health University Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Medical Center	SC	Specialist	$0	$17.1M
Agapi Behavioral Consultants	SC	Behavior Analyst	$0	$15M
St Francis Hospital, Inc.	SC	General Acute Care Hospital	$0	$13M
Eastside Pediatric Dentistry PA	SC	Pediatric Dentistry	$0	$10M
Magnolia Medical Group Inc	SC	Physical Therapist	$0	$9.9M
Greenville Health Corporation	SC	Durable Medical Equipment & Medical Supplies	$0	$8.9M
D&s Community Services Sc, LLC	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.3M
Bloom Behavioral Therapy LLC	SC	Mental Health Counselor	$0	$7.5M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$6.4M
Clemson Eye, PA	SC	Ophthalmology Physician	$0	$5.5M

Prisma Health University Medical Group — Billing Profile & Reimbursement Data

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Prisma Health University Medical Group — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References