Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $6.37M by Medicaid between Jan 2018 and Dec 2024, across 151 billing codes. Its largest line is 36415, Collection of venous blood by venipuncture — 35% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29615
GREENVILLE, SC 29615
33aNPI1144775032assigned 08/20/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$6.37M
24GClaims215,476
24DCodes billed151
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#47 of 115
Median peer was paid$2.47M
This provider vs. median2.6×
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 | 33,719 | $694K | |
| 2019 | 39,025 | $774K | |
| 2020 | 35,893 | $759K | |
| 2021 | 42,009 | $1.03M | |
| 2022 | 27,909 | $947K | |
| 2023 | 19,030 | $1.10M | |
| 2024incomplete | 17,891 | $1.08M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 36415 | Collection of venous blood by venipuncture | 35% | 27,868 | 26,208 | $2.24M |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 7.8% | 4,410 | 4,290 | $495K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 7.5% | 332 | 330 | $480K |
| 77066 | Tomosynthesis, mammo | 5.4% | 2,663 | 2,609 | $343K |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | 4.9% | 3,047 | 2,951 | $309K |
| 88300 | 4.2% | 2,248 | 2,226 | $266K | |
| 76770 | 4.1% | 1,841 | 1,833 | $259K | |
| 76642 | 3.8% | 7,115 | 5,949 | $239K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 3.3% | 297 | 293 | $212K |
| 81025 | 3.1% | 1,277 | 1,259 | $198K | |
| 74018 | 2.7% | 5,953 | 5,732 | $172K | |
| 42830 | 2.4% | 928 | 915 | $154K |
139 more codes
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 2.3% | 1,838 | $148K |
| 77065 | Tomosynthesis, mammo | 2.2% | 2,636 | $143K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1.2% | 151 | $76K |
| 87070 | 1.1% | 1,246 | $73K | |
| 77072 | <1% | 2,302 | $54K | |
| 82565 | <1% | 186 | $40K | |
| 82657 | <1% | 310 | $39K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | <1% | 57 | $39K |
| 88304 | <1% | 392 | $39K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 1,222 | $37K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 2,369 | $36K |
| 87081 | <1% | 211 | $32K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 2,459 | $26K |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 12,067 | $25K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 248 | $25K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 182 | $21K |
| 76775 | <1% | 218 | $20K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 164 | $14K |
| 72141 | <1% | 13 | $13K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 70 | $11K |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 439 | $10K |
| 71250 | <1% | 24 | $9K | |
| 80053 | Comprehensive metabolic panel | <1% | 9,995 | $9K |
| 19083 | <1% | 337 | $9K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 25 | $7K |
| 76830 | Ultrasound, transvaginal | <1% | 12 | $5K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 28 | $5K |
| A4648 | Tissue marker, implantable, any type, each | <1% | 484 | $4K |
| 73630 | <1% | 51 | $4K | |
| 00170 | Anesthesia for intraoral procedures, including biopsy | <1% | 42 | $3K |
| 54161 | <1% | 114 | $3K | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 3,494 | $3K |
| 87077 | <1% | 274 | $3K | |
| 78264 | <1% | 12 | $3K | |
| 81001 | <1% | 797 | $2K | |
| 82784 | <1% | 2,777 | $1K | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | <1% | 1,489 | $1K |
| 82570 | <1% | 1,444 | $1K | |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 1,439 | $1K |
| 72100 | <1% | 38 | $1K | |
| 80069 | <1% | 1,134 | $957.82 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 7,923 | $944.31 |
| 93976 | <1% | 24 | $734.51 | |
| 00126 | <1% | 12 | $588.49 | |
| 80061 | Lipid panel | <1% | 3,045 | $587.07 |
| 86140 | <1% | 3,418 | $562.34 | |
| 82785 | <1% | 1,085 | $489.23 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 4,143 | $418.95 |
| 82043 | <1% | 636 | $397.97 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 12 | $387.73 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 1,365 | $343.28 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,083 | $311.98 |
| 83516 | <1% | 2,037 | $268.52 | |
| 73130 | <1% | 16 | $249.55 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 1,116 | $216.00 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | <1% | 1,918 | $208.88 |
| 82670 | <1% | 135 | $182.15 | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 13 | $172.77 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 8,367 | $149.82 |
| 76942 | <1% | 83 | $138.47 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 6,365 | $129.21 |
| 82310 | <1% | 15 | $127.36 | |
| 80197 | <1% | 110 | $117.03 | |
| 84403 | <1% | 435 | $115.88 | |
| 86003 | <1% | 689 | $99.18 | |
| 84439 | <1% | 4,366 | $93.83 | |
| 80076 | <1% | 772 | $93.15 | |
| 82728 | <1% | 1,281 | $69.49 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 7,859 | $59.79 |
| 86255 | <1% | 964 | $48.72 | |
| 81003 | <1% | 99 | $35.48 | |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | <1% | 900 | $29.45 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 90 | $28.41 |
| 85027 | <1% | 3,495 | $12.49 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 5,259 | $11.84 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 1,006 | $7.68 |
| 86317 | 0% | 176 | $0.00 | |
| 83735 | 0% | 2,170 | $0.00 | |
| 86800 | 0% | 429 | $0.00 | |
| J1170 | Injection, hydromorphone, up to 4 mg | 0% | 2,506 | $0.00 |
| 83519 | 0% | 657 | $0.00 | |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | 0% | 751 | $0.00 |
| J3490 | Unclassified drugs | 0% | 5,027 | $0.00 |
| 83001 | 0% | 209 | $0.00 | |
| 82550 | 0% | 98 | $0.00 | |
| 87205 | 0% | 1,174 | $0.00 | |
| 86160 | 0% | 121 | $0.00 | |
| 86376 | 0% | 674 | $0.00 | |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 0% | 198 | $0.00 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 0% | 1,914 | $0.00 |
| 83520 | 0% | 80 | $0.00 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 90 | $0.00 |
| 85651 | 0% | 2,937 | $0.00 | |
| 85652 | 0% | 1,121 | $0.00 | |
| 82607 | 0% | 240 | $0.00 | |
| 83002 | 0% | 258 | $0.00 | |
| 80177 | 0% | 13 | $0.00 | |
| 42821 | 0% | 25 | $0.00 | |
| 84480 | 0% | 42 | $0.00 | |
| 83498 | 0% | 26 | $0.00 | |
| 83880 | 0% | 28 | $0.00 | |
| 86364 | 0% | 79 | $0.00 | |
| 82533 | 0% | 13 | $0.00 | |
| 87340 | 0% | 12 | $0.00 | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 0% | 39 | $0.00 |
| 84134 | 0% | 27 | $0.00 | |
| 86341 | 0% | 15 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 0% | 25 | $0.00 |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 0% | 12 | $0.00 |
| 84402 | 0% | 13 | $0.00 | |
| 84446 | 0% | 25 | $0.00 | |
| 83540 | 0% | 1,071 | $0.00 | |
| 84305 | 0% | 1,113 | $0.00 | |
| 84156 | 0% | 241 | $0.00 | |
| 82610 | 0% | 1,252 | $0.00 | |
| 85007 | 0% | 1,445 | $0.00 | |
| 83970 | 0% | 1,351 | $0.00 | |
| 84100 | 0% | 2,181 | $0.00 | |
| 85610 | 0% | 593 | $0.00 | |
| 82977 | 0% | 609 | $0.00 | |
| 86038 | 0% | 369 | $0.00 | |
| 84466 | 0% | 1,049 | $0.00 | |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 0% | 279 | $0.00 |
| 87186 | 0% | 436 | $0.00 | |
| 80164 | 0% | 54 | $0.00 | |
| J1171 | Injection, hydromorphone, 0.1 mg | 0% | 43 | $0.00 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 0% | 13 | $0.00 |
| J2004 | Injection, lidocaine hcl with epinephrine, 1 mg | 0% | 46 | $0.00 |
| 86235 | 0% | 12 | $0.00 | |
| 86337 | 0% | 15 | $0.00 | |
| 82627 | 0% | 29 | $0.00 | |
| 86480 | 0% | 12 | $0.00 | |
| 86774 | 0% | 12 | $0.00 | |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 0% | 28 | $0.00 |
| 84146 | 0% | 12 | $0.00 | |
| 88312 | 0% | 27 | $0.00 | |
| D1120 | Dental cleaning, child | 0% | 16 | $0.00 |
| 84590 | 0% | 12 | $0.00 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 27 | $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 (SVP FINANCE, ENTERPRISE CONTRACTING)
| 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 | $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.