Clinic
Prisma Health-Upstate
Prisma Health-Upstate was paid $3.89M by Medicaid between Jan 2018 and Dec 2024, across 38 billing codes. Its largest line is 70553, Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences — 26% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29605
GREENVILLE, SC 29605
33aNPI1235685330assigned 08/29/2016
33bProvider typeRadiology Clinic/Center
28Total paid$3.89M
24GClaims30,315
24DCodes billed38
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Radiology Clinic/Center providers in South Carolina
Rank by total paid#1 of 6
Median peer was paid$12K
This provider vs. median331×
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 | 4,126 | $636K | |
| 2019 | 4,449 | $562K | |
| 2020 | 4,023 | $463K | |
| 2021 | 4,760 | $589K | |
| 2022 | 4,758 | $586K | |
| 2023 | 4,849 | $562K | |
| 2024incomplete | 3,350 | $497K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | 26% | 709 | 704 | $1.01M |
| 76830 | Ultrasound, transvaginal | 17% | 2,059 | 2,022 | $648K |
| 82565 | 12% | 1,121 | 1,104 | $456K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | 6.6% | 651 | 647 | $258K |
| 77063 | Screening digital breast tomosynthesis, bilateral | 6.2% | 2,361 | 2,337 | $240K |
| 71250 | 6.1% | 934 | 909 | $236K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | 3.6% | 181 | 177 | $140K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | 3.1% | 924 | 911 | $120K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 3.0% | 897 | 882 | $118K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | 2.6% | 1,107 | 1,094 | $99K |
| 71046 | Radiologic examination, chest; 2 views | 2.1% | 2,890 | 2,808 | $82K |
| 36415 | Collection of venous blood by venipuncture | 2.0% | 483 | 474 | $80K |
26 more codes
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1.9% | 120 | $74K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 1.5% | 1,794 | $58K |
| 76770 | 1.3% | 458 | $52K | |
| 74018 | 1.3% | 1,228 | $50K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | 1.0% | 3,099 | $39K |
| 76775 | <1% | 487 | $36K | |
| 72100 | <1% | 762 | $32K | |
| 76536 | <1% | 219 | $22K | |
| 77080 | <1% | 94 | $16K | |
| 93971 | <1% | 24 | $7K | |
| 71271 | <1% | 37 | $5K | |
| 73630 | <1% | 66 | $3K | |
| 73560 | <1% | 59 | $3K | |
| 74230 | <1% | 34 | $2K | |
| 93976 | <1% | 669 | $2K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 2,687 | $1K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 361 | $1K |
| 73030 | <1% | 38 | $1K | |
| 72040 | <1% | 12 | $1K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 166 | $577.29 |
| 73501 | <1% | 12 | $166.28 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | <1% | 2,095 | $128.94 |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 1,393 | $56.63 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 0% | 25 | $0.00 |
| 92611 | 0% | 33 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 26 | $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.