Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $967K by Medicaid between Jan 2018 and Nov 2024, across 85 billing codes. Its largest line is A9552, Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries — 25% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29615
GREENVILLE, SC 29615
33aNPI1124574223assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$967K
24GClaims46,555
24DCodes billed85
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#71 of 115
Median peer was paid$2.47M
This provider vs. median0.4×
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 | 3,092 | $41K | |
| 2019 | 4,337 | $47K | |
| 2020 | 5,567 | $82K | |
| 2021 | 8,979 | $142K | |
| 2022 | 8,904 | $248K | |
| 2023 | 7,963 | $166K | |
| 2024incomplete | 7,713 | $239K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 25% | 137 | 137 | $239K |
| 36415 | Collection of venous blood by venipuncture | 22% | 2,879 | 2,386 | $215K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 2,467 | 2,262 | $145K |
| 81025 | 5.2% | 406 | 392 | $50K | |
| 64493 | 4.9% | 398 | 386 | $48K | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 4.4% | 359 | 349 | $43K |
| 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | 3.6% | 166 | 162 | $35K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 2.5% | 539 | 480 | $24K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.5% | 418 | 354 | $24K |
| 80053 | Comprehensive metabolic panel | 1.8% | 1,083 | 1,007 | $18K |
| 87070 | 1.8% | 996 | 944 | $17K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 1.6% | 542 | 511 | $15K |
73 more codes
| 96376 | 1.3% | 248 | $12K | |
| 87077 | 1.2% | 496 | $11K | |
| J3490 | Unclassified drugs | 1.1% | 3,548 | $11K |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 1,024 | $9K |
| 59025 | Fetal non-stress test | <1% | 617 | $8K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 410 | $4K |
| 86850 | <1% | 193 | $4K | |
| 81001 | <1% | 498 | $3K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 46 | $3K |
| 82570 | <1% | 471 | $3K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 13 | $3K |
| 78815 | Positron emission tomography (PET) for limited area imaging | <1% | 98 | $3K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 544 | $2K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | <1% | 34 | $2K |
| 85610 | <1% | 72 | $2K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 54 | $2K |
| 82247 | <1% | 91 | $2K | |
| 83993 | <1% | 43 | $2K | |
| 85027 | <1% | 1,431 | $1K | |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 13 | $1K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 882 | $1K |
| G0378 | Hospital observation service, per hour | <1% | 810 | $914.86 |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 284 | $833.79 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 256 | $785.77 |
| 87081 | <1% | 306 | $665.16 | |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 154 | $611.95 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 2,580 | $445.36 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | <1% | 476 | $210.04 |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 2,834 | $82.48 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | <1% | 1,019 | $53.72 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 29 | $48.70 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | <1% | 441 | $24.52 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 2,509 | $21.53 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 54 | $15.93 |
| 84156 | <1% | 131 | $4.87 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 2,869 | $0.93 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 2,084 | $0.42 |
| J1170 | Injection, hydromorphone, up to 4 mg | 0% | 1,953 | $0.00 |
| J2370 | Injection, phenylephrine hcl, up to 1 ml | 0% | 436 | $0.00 |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 0% | 626 | $0.00 |
| 87205 | 0% | 400 | $0.00 | |
| 85018 | 0% | 88 | $0.00 | |
| 97162 | 0% | 159 | $0.00 | |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 0% | 324 | $0.00 |
| 86901 | 0% | 189 | $0.00 | |
| 88307 | 0% | 67 | $0.00 | |
| 64494 | 0% | 116 | $0.00 | |
| 51798 | 0% | 26 | $0.00 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 71 | $0.00 |
| 96375 | Therapeutic injection; each additional sequential IV push | 0% | 134 | $0.00 |
| 93320 | 0% | 140 | $0.00 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 27 | $0.00 |
| 64483 | 0% | 13 | $0.00 | |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 0% | 21 | $0.00 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 0% | 145 | $0.00 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 0% | 1,707 | $0.00 |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 0% | 170 | $0.00 |
| J0735 | Injection, clonidine hydrochloride, 1 mg | 0% | 119 | $0.00 |
| J3370 | Injection, vancomycin hcl, 500 mg | 0% | 105 | $0.00 |
| 86900 | 0% | 189 | $0.00 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 0% | 86 | $0.00 |
| 87186 | 0% | 364 | $0.00 | |
| C1776 | Joint device (implantable) | 0% | 154 | $0.00 |
| 85014 | 0% | 83 | $0.00 | |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 0% | 87 | $0.00 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 0% | 19 | $0.00 |
| J1644 | Injection, heparin sodium, per 1000 units | 0% | 63 | $0.00 |
| J1596 | Injection, glycopyrrolate, 0.1 mg | 0% | 59 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 0% | 42 | $0.00 |
| J2270 | Injection, morphine sulfate, up to 10 mg | 0% | 15 | $0.00 |
| 82248 | 0% | 48 | $0.00 | |
| 93325 | 0% | 141 | $0.00 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 117 | $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 | $8.32M |
| 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.