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    v1.0.28
    OpenPayerNPI Medicare & MedicaidPrisma Health-midlands
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    Prisma Health-midlands — Billing Profile & Reimbursement Data

    NPI 1760590954 · Columbia, SC · Home Health Agency

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    Prisma Health-midlands is a home health agency provider located in Columbia, South Carolina. This profile covers 0 Medicare and 6 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPrisma Health-midlands
    Address1205 Colonial Life Blvd W
    CityColumbia
    StateSC
    ZIP29210
    TaxonomyHome Health Agency
    NPI EnumeratedAugust 28, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.6M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    6 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1030Nursing care, in the home, by registered nurse, per diem21,420$90$1.9M
    S9131Physical therapy; in the home, per diem17,350$100$1.8M
    S9129Occupational therapy, in the home, per diem6,350$100$641.8K
    S9128Speech therapy, in the home, per diem2,970$100$282.1K
    A9900Miscellaneous dme supply, accessory, and/or service component of another hcpcs code70$50$3.9K
    S9127Social work visit, in the home, per diem80$0$0

    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.

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

    6 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1030Nursing care, in the home, by registered nurse, per diem3503,370$90$545.7K
    S9131Physical therapy; in the home, per diem2402,390$100$393.9K
    S9129Occupational therapy, in the home, per diem330630$100$188.2K
    S9128Speech therapy, in the home, per diem210590$100$140.2K
    A9900Miscellaneous dme supply, accessory, and/or service component of another hcpcs code1110560$110$120.8K
    S9127Social work visit, in the home, per diem11040$80$3.4K

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Prisma Health University Medical GroupSCFamily Medicine Physician$0$171.7M
    Prisma Health Medical Group-midlandsSCMulti-Specialty Clinic/Center$0$77.6M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$74.6M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$68.3M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$28.1M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$11.8M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$7.4M
    Prisma Health-midlandsSCGeneral Acute Care Hospital$0$6.9M
    Prisma Health TuomeySCEmergency Medicine Physician$0$6.8M
    Prisma Health-midlandsSCEmergency Medicine Physician$0$6.8M

    Nearby Providers

    Other providers in the same ZIP code as Prisma Health-midlands, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    South Carolina Youth Advocate ProgramSCCommunity/Behavioral Health Agency$0$64M
    Lifehme, Inc.SCOxygen Equipment & Supplies (DME)$0$45.6M
    Pal-med, LLCSCDurable Medical Equipment & Medical Supplies$0$26.2M
    Bright Start, LLCSCSpeech-Language Pathologist$0$20.8M
    Kids First Dental, LLCSCDentist$0$20.6M
    Hospice Care Of South Carolina, Lowcountry, LLCSCCommunity Based Hospice Care Agency$0$19.9M
    Crescent Hospice, Inc.SCCommunity Based Hospice Care Agency$0$17.3M
    Coram Healthcare/carolina Home TherapeuticsSCHome Infusion Therapy Pharmacy$0$13.9M
    Caring Healthcare, Inc.SCNursing Care Agency$0$13.3M
    Richland/lexington Disabilities And Special Needs BoardSCCase Management Agency$0$11.3M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. South Carolina Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. South Carolina Distribution
    Prisma Health-midlands — 2 of 5 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Carolina