Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Hospital

Prisma Health-Upstate

Prisma Health-Upstate was paid $13.11M by Medicaid between Jan 2018 and Dec 2024, across 196 billing codes. Its largest line is 36415, Collection of venous blood by venipuncture — 12% of everything it billed.

33Billing provider infoPRISMA HEALTH-UPSTATE
CLINTON, SC 29325
33aNPI1245786367assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$13.11M
24GClaims575,112
24DCodes billed196
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other General Acute Care Hospital providers in South Carolina

Rank by total paid#25 of 115
Median peer was paid$2.47M
This provider vs. median5.3×

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

$0$100K$200K$300K2018201920202021202220232024
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
YearClaimsPaid
201864,279$1.53M
201982,452$1.68M
202072,143$1.51M
202194,752$1.93M
202298,984$2.30M
202394,962$2.49M
2024incomplete67,540$1.69M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
36415 Collection of venous blood by venipuncture 12% 19,028 13,744 $1.53M
80053 Comprehensive metabolic panel 10% 24,304 21,418 $1.36M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 8.6% 27,962 26,060 $1.13M
99282 Emergency department visit for the evaluation and management, low to moderate severity 6.6% 6,504 6,303 $869K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 4.2% 5,983 5,712 $555K
80048 Basic metabolic panel (calcium, ionized) 4.1% 14,087 10,980 $537K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 3.7% 13,093 8,192 $487K
81025 2.9% 10,406 9,721 $382K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 2.7% 10,644 6,861 $354K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 2.6% 3,241 2,950 $337K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm 2.5% 778 364 $328K
96361 Intravenous infusion, hydration; each additional hour 2.5% 8,715 6,745 $326K
184 more codes
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 2.1% 9,711 $281K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 2.1% 7,914 $280K
81001 1.9% 18,837 $255K
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 1.5% 4,515 $196K
76830 Ultrasound, transvaginal 1.4% 638 $188K
87070 1.3% 1,183 $169K
87081 1.3% 2,643 $166K
87086 Culture, bacterial; quantitative colony count, urine 1.3% 10,712 $165K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 1.2% 3,031 $162K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.1% 738 $138K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 1.0% 4,676 $131K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 12,881 $130K
99284 Emergency room visit (serious) <1% 15,816 $127K
70450 Computed tomography, head or brain; without contrast material <1% 3,695 $115K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 2,253 $107K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 3,727 $97K
87077 <1% 3,917 $91K
73630 <1% 1,674 $86K
85018 <1% 14,016 $82K
97597 <1% 2,027 $81K
73610 <1% 1,376 $78K
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 3,521 $74K
71046 Radiologic examination, chest; 2 views <1% 4,095 $73K
71045 Radiologic examination, chest; single view <1% 8,503 $68K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 3,203 $65K
81003 <1% 16,304 $58K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 2,764 $58K
73130 <1% 623 $57K
73564 <1% 1,465 $54K
71250 <1% 139 $52K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 402 $52K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 13,561 $49K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 34,836 $46K
80047 <1% 728 $44K
74176 Computed tomography, abdomen and pelvis; without contrast material <1% 1,134 $44K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 838 $44K
99285 Emergency room visit (most serious) <1% 14,360 $44K
73030 <1% 1,014 $41K
87210 <1% 1,899 $40K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 1,077 $40K
86900 <1% 1,090 $39K
86850 <1% 550 $34K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 1,592 $32K
84702 <1% 1,667 $31K
73110 <1% 439 $30K
80061 Lipid panel <1% 7,002 $29K
83036 Hemoglobin; glycosylated (A1C) <1% 7,093 $28K
74018 <1% 805 $27K
87807 <1% 1,570 $26K
77063 Screening digital breast tomosynthesis, bilateral <1% 234 $25K
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV <1% 510 $23K
77067 Screening mammography, bilateral, including computer-aided detection <1% 925 $20K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 103 $20K
72100 <1% 826 $19K
71275 Computed tomographic angiography, chest, with contrast material <1% 573 $18K
93971 <1% 65 $16K
84443 Thyroid stimulating hormone (TSH) <1% 8,122 $15K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 185 $14K
97162 <1% 1,018 $14K
99213 Doctor's office visit, returning patient (routine) <1% 425 $14K
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% 948 $13K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 89 $13K
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 2,021 $13K
99214 Doctor's office visit, returning patient (more involved) <1% 814 $13K
96375 Therapeutic injection; each additional sequential IV push <1% 7,747 $13K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 1,718 $12K
G0378 Hospital observation service, per hour <1% 2,902 $12K
84439 <1% 1,687 $11K
97032 <1% 98 $11K
J7120 Ringers lactate infusion, up to 1000 cc <1% 3,778 $10K
85027 <1% 4,075 $10K
86308 <1% 390 $10K
93017 <1% 63 $8K
82043 <1% 1,081 $8K
86780 <1% 187 $7K
82607 <1% 925 $7K
87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies <1% 590 $7K
J7030 Infusion, normal saline solution , 1000 cc <1% 8,815 $6K
87428 <1% 87 $6K
80076 <1% 1,841 $6K
82565 <1% 59 $6K
J3490 Unclassified drugs <1% 3,513 $5K
83690 <1% 6,802 $5K
J1815 Injection, insulin, per 5 units <1% 2,133 $5K
84484 <1% 7,168 $5K
J1644 Injection, heparin sodium, per 1000 units <1% 1,382 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 307 $4K
85610 <1% 3,453 $4K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 27 $4K
73502 <1% 147 $3K
74022 <1% 305 $3K
86803 <1% 831 $3K
12001 <1% 41 $3K
72125 Computed tomography, cervical spine; without contrast material <1% 991 $3K
83540 <1% 979 $3K
82728 <1% 486 $3K
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 993 $3K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 2,790 $3K
85007 <1% 1,140 $3K
82947 <1% 357 $3K
J2270 Injection, morphine sulfate, up to 10 mg <1% 3,293 $3K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 6,679 $3K
85379 <1% 1,685 $3K
86580 <1% 205 $2K
73080 <1% 50 $2K
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 3,362 $2K
86140 <1% 1,830 $2K
83880 <1% 2,560 $2K
73140 <1% 16 $2K
87400 <1% 25 $2K
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 2,756 $2K
82570 <1% 1,032 $2K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) <1% 778 $2K
83735 <1% 7,474 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 7,062 $1K
J1650 Injection, enoxaparin sodium, 10 mg <1% 1,422 $1K
96376 <1% 3,426 $1K
J3475 Injection, magnesium sulfate, per 500 mg <1% 607 $1K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 5,147 $1K
84145 <1% 1,045 $926.49
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 13 $917.77
T1015 A visit at a community health center or clinic (one all-in rate) <1% 50 $897.69
85730 <1% 1,056 $809.47
93976 <1% 766 $762.84
80143 <1% 228 $703.32
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals <1% 48 $661.69
82077 <1% 1,315 $654.33
82550 <1% 413 $625.79
73562 <1% 13 $511.80
82746 <1% 196 $498.47
82803 <1% 308 $480.96
84100 <1% 2,091 $465.35
76642 <1% 13 $437.73
82962 <1% 23 $423.28
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 14 $420.18
59025 Fetal non-stress test <1% 86 $407.94
86038 <1% 27 $398.89
J2550 Injection, promethazine hcl, up to 50 mg <1% 1,307 $393.28
81002 <1% 435 $341.89
87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types <1% 25 $258.11
73590 <1% 28 $253.02
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 1,190 $177.27
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 13 $163.20
97161 <1% 25 $152.54
97166 <1% 61 $147.68
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program <1% 3,710 $144.05
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 181 $111.75
83605 <1% 3,503 $92.39
87040 <1% 1,507 $87.50
86480 <1% 17 $82.29
84156 <1% 34 $49.34
87186 <1% 3,096 $47.17
90715 <1% 238 $40.37
70496 <1% 12 $31.95
80179 <1% 113 $13.42
84550 <1% 53 $6.88
J1170 Injection, hydromorphone, up to 4 mg <1% 1,495 $6.53
85652 <1% 821 $6.38
87205 <1% 492 $4.46
J0690 Injection, cefazolin sodium, 500 mg <1% 141 $4.09
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 2,155 $2.08
85651 <1% 490 $0.90
J1200 Injection, diphenhydramine hcl, up to 50 mg 0% 937 $0.00
J2272 Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg 0% 963 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 0% 274 $0.00
84466 0% 631 $0.00
J7040 Infusion, normal saline solution, sterile (500 ml = 1 unit) 0% 80 $0.00
96367 0% 130 $0.00
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting 0% 49 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 0% 229 $0.00
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 0% 12 $0.00
J2300 Injection, nalbuphine hydrochloride, per 10 mg 0% 134 $0.00
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) 0% 15 $0.00
86901 0% 1,089 $0.00
J2060 Injection, lorazepam, 2 mg 0% 386 $0.00
J2250 Injection, midazolam hydrochloride, per 1 mg 0% 471 $0.00
J7512 Prednisone, immediate release or delayed release, oral, 1 mg 0% 1,086 $0.00
J3010 Injection, fentanyl citrate, 0.1 mg 0% 391 $0.00
A9585 Injection, gadobutrol, 0.1 ml 0% 28 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 0% 28 $0.00
J0131 Injection, acetaminophen, not otherwise specified,10 mg 0% 106 $0.00
J0500 Injection, dicyclomine hcl, up to 20 mg 0% 12 $0.00
J3480 Injection, potassium chloride, per 2 meq 0% 48 $0.00
70498 0% 12 $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)
Same official

Other billing entities under MILLER, POLLY

Full network →
ProviderLocationPaid
Prisma Health-MidlandsColumbia, SC$74.58M
Prisma Health-MidlandsColumbia, SC$68.26M
Prisma Health-UpstateGreenville, SC$25.04M
Prisma Health-UpstateGreenville, SC$21.98M
Prisma Health-UpstateGreenville, SC$19.69M
Prisma Health-UpstateSeneca, SC$15.64M
Prisma Health-MidlandsColumbia, SC$11.77M
Prisma Health-UpstateGreenville, SC$10.74M
Greenville Health CorporationGreenville, SC$8.90M
Prisma Health-UpstateGreenville, SC$8.32M
Prisma Health-UpstateGreenville, SC$7.45M
Prisma Health University Medical GroupGreenville, SC$7.44M
Prisma Health-MidlandsCoulmbia, SC$7.43M
Prisma Health-MidlandsColumbia, SC$6.88M
Prisma Health TuomeySumter, SC$6.84M
Prisma Health-MidlandsColumbia, SC$6.77M
Prisma Health-UpstateGreenville, SC$6.37M
Prisma Health-UpstateGreenville, SC$5.00M
Prisma Health-UpstateGreenville, SC$4.65M
Prisma Health-MidlandsColumbia, SC$4.63M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.