Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $8.32M by Medicaid between Jan 2018 and Nov 2024, across 51 billing codes. Its largest line is 96365, Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour — 46% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29605
GREENVILLE, SC 29605
33aNPI1114473212assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$8.32M
24GClaims73,396
24DCodes billed51
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#38 of 115
Median peer was paid$2.47M
This provider vs. median3.4×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MILLER, POLLY controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 10,017 | $574K | |
| 2019 | 11,856 | $1.17M | |
| 2020 | 11,283 | $1.93M | |
| 2021 | 11,493 | $2.28M | |
| 2022 | 12,814 | $1.50M | |
| 2023 | 7,697 | $403K | |
| 2024incomplete | 8,236 | $459K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 46% | 3,745 | 1,974 | $3.80M |
| 36415 | Collection of venous blood by venipuncture | 21% | 11,917 | 6,714 | $1.72M |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 15% | 2,819 | 1,969 | $1.29M |
| 77336 | 5.8% | 1,618 | 666 | $487K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.8% | 8,631 | 5,819 | $237K |
| 77300 | 2.1% | 234 | 189 | $171K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 1.3% | 683 | 387 | $108K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.3% | 3,419 | 2,638 | $106K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.1% | 2,745 | 2,426 | $91K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,396 | 1,265 | $71K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 360 | 217 | $47K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 1,932 | 1,097 | $39K |
39 more codes
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 7,520 | $36K |
| 80053 | Comprehensive metabolic panel | <1% | 720 | $21K |
| 77386 | <1% | 618 | $14K | |
| 96367 | <1% | 66 | $14K | |
| 85007 | <1% | 603 | $14K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 899 | $13K |
| 36430 | <1% | 107 | $11K | |
| 77334 | <1% | 284 | $10K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 205 | $9K |
| 80076 | <1% | 4,741 | $3K | |
| 86850 | <1% | 401 | $3K | |
| 77412 | <1% | 176 | $3K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 9,370 | $982.65 |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 39 | $865.42 |
| 83735 | <1% | 1,856 | $779.05 | |
| P9016 | Red blood cells, leukocytes reduced, each unit | <1% | 19 | $585.80 |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 35 | $394.16 |
| 86304 | <1% | 99 | $241.12 | |
| 83615 | <1% | 182 | $155.08 | |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 22 | $133.54 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 544 | $27.23 |
| 86901 | 0% | 401 | $0.00 | |
| 96415 | 0% | 119 | $0.00 | |
| 85027 | 0% | 664 | $0.00 | |
| 82728 | 0% | 138 | $0.00 | |
| J2469 | Injection, palonosetron hcl, 25 mcg | 0% | 136 | $0.00 |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 130 | $0.00 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | 0% | 313 | $0.00 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 1,469 | $0.00 |
| 84466 | 0% | 147 | $0.00 | |
| 84439 | 0% | 55 | $0.00 | |
| 83540 | 0% | 147 | $0.00 | |
| 86900 | 0% | 402 | $0.00 | |
| 96417 | 0% | 42 | $0.00 | |
| J1453 | Injection, fosaprepitant, 1 mg | 0% | 38 | $0.00 |
| J0897 | Injection, denosumab, 1 mg | 0% | 17 | $0.00 |
| 86923 | 0% | 54 | $0.00 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 102 | $0.00 |
| 84100 | 0% | 17 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMILLER, POLLY (VP PAYOR STRATEGIES & ALIGNMENT)
| Provider | Location | 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 | $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 |
| Prisma Health-Upstate | Seneca, SC | $4.48M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.