Dental
Prisma Health Medical Group-Midlands
Prisma Health Medical Group-Midlands was paid $77.82M by Medicaid between Jan 2018 and Dec 2024, across 224 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 18% of everything it billed.
33Billing provider infoPRISMA HEALTH MEDICAL GROUP-MIDLANDS
COLUMBIA, SC 29203
COLUMBIA, SC 29203
33aNPI1275988321assigned 04/26/2016
33bProvider typeDentist
28Total paid$77.82M
24GClaims1,120,638
24DCodes billed224
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dentist providers in South Carolina
Rank by total paid#1 of 166
Median peer was paid$67K
This provider vs. median1,169×
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 LAWRENCE, KRISTI 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 | 119,242 | $8.58M | |
| 2019 | 134,962 | $9.26M | |
| 2020 | 123,340 | $9.52M | |
| 2021 | 149,966 | $10.94M | |
| 2022 | 196,422 | $13.71M | |
| 2023 | 200,916 | $13.38M | |
| 2024incomplete | 195,790 | $12.43M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 18% | 203,119 | 191,681 | $14.32M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 12% | 199,155 | 182,315 | $9.65M |
| 90378 | 8.5% | 2,243 | 1,443 | $6.65M | |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 7.2% | 64,710 | 62,953 | $5.59M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.2% | 26,803 | 25,852 | $3.23M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 3.7% | 58,453 | 57,009 | $2.87M |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 3.5% | 18,071 | 17,478 | $2.71M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.4% | 54,130 | 21,163 | $2.67M |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 2.7% | 19,394 | 17,971 | $2.07M |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 2.5% | 15,778 | 15,155 | $1.91M |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 2.2% | 19,886 | 15,166 | $1.68M |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.6% | 10,393 | 10,152 | $1.27M |
212 more codes
| 14040 | 1.5% | 3,336 | $1.16M | |
| 95816 | 1.5% | 4,551 | $1.14M | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 1.4% | 7,377 | $1.11M |
| 54360 | 1.3% | 1,683 | $1.03M | |
| 93304 | 1.3% | 8,303 | $997K | |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | 1.1% | 794 | $883K |
| 99243 | 1.1% | 7,868 | $861K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 5,005 | $541K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 18,873 | $533K |
| 93308 | <1% | 8,287 | $526K | |
| 76818 | <1% | 5,707 | $511K | |
| 95720 | <1% | 3,637 | $509K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 7,925 | $479K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 5,954 | $459K |
| 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | <1% | 2,123 | $451K |
| 95951 | <1% | 2,055 | $439K | |
| 99223 | Prolong inpt eval add15 m | <1% | 3,151 | $422K |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 6,298 | $408K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 5,564 | $401K |
| 93325 | <1% | 18,611 | $373K | |
| J0585 | Injection, onabotulinumtoxina, 1 unit | <1% | 492 | $358K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 11,822 | $348K |
| 99219 | <1% | 3,123 | $342K | |
| 93321 | <1% | 16,613 | $331K | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 2,029 | $323K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 3,174 | $312K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 3,110 | $306K |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 2,793 | $300K |
| 94010 | <1% | 13,534 | $300K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 3,644 | $286K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 2,593 | $272K |
| 95819 | <1% | 931 | $272K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 3,843 | $263K |
| 92015 | Determination of refractive state | <1% | 16,472 | $261K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 4,032 | $249K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 3,670 | $249K |
| 99245 | <1% | 1,366 | $247K | |
| 92060 | <1% | 5,828 | $244K | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 2,822 | $227K |
| 95782 | <1% | 1,704 | $195K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 2,480 | $191K |
| 76820 | <1% | 4,807 | $186K | |
| G9008 | Coordinated care fee, physician coordinated care oversight services | <1% | 2,459 | $174K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 3,202 | $165K |
| 93000 | <1% | 12,565 | $154K | |
| 76830 | Ultrasound, transvaginal | <1% | 1,951 | $138K |
| 54161 | <1% | 1,553 | $135K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 1,888 | $133K |
| G9153 | Mapcp demonstration - physician incentive pool | <1% | 2,005 | $111K |
| 97803 | <1% | 3,094 | $102K | |
| 99254 | <1% | 599 | $91K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 10,069 | $86K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 1,610 | $83K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 1,014 | $82K |
| 99205 | Prolong outpt/office vis | <1% | 516 | $80K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 527 | $80K |
| 01922 | <1% | 334 | $75K | |
| 99472 | Subsequent inpatient pediatric critical care, per day, 2-5 years | <1% | 177 | $72K |
| 95117 | <1% | 9,174 | $72K | |
| 92083 | <1% | 1,725 | $70K | |
| 81003 | <1% | 30,660 | $70K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 9,328 | $68K |
| 99417 | Prolong home eval add 15m | <1% | 1,853 | $66K |
| 90836 | <1% | 998 | $62K | |
| 94375 | <1% | 2,426 | $61K | |
| 76770 | <1% | 889 | $61K | |
| 99241 | <1% | 1,364 | $60K | |
| 95813 | <1% | 1,135 | $56K | |
| 76801 | <1% | 558 | $53K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 496 | $52K |
| 99242 | <1% | 760 | $52K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 20,830 | $50K |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 131 | $47K |
| 99217 | <1% | 730 | $44K | |
| 59514 | <1% | 45 | $44K | |
| 97802 | <1% | 1,059 | $43K | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 624 | $42K |
| 64642 | <1% | 486 | $41K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 314 | $39K |
| 99234 | <1% | 337 | $38K | |
| 99235 | <1% | 251 | $38K | |
| 92133 | <1% | 1,570 | $35K | |
| 54163 | <1% | 352 | $34K | |
| 93888 | <1% | 1,294 | $33K | |
| 59430 | <1% | 315 | $29K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 545 | $28K |
| 99460 | <1% | 333 | $28K | |
| 43775 | <1% | 38 | $28K | |
| 99336 | <1% | 330 | $27K | |
| 99255 | <1% | 132 | $24K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 771 | $24K |
| 99220 | <1% | 149 | $22K | |
| 99188 | <1% | 1,252 | $22K | |
| 53460 | <1% | 71 | $18K | |
| 76775 | <1% | 250 | $18K | |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 698 | $18K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,150 | $17K |
| J0248 | Injection, remdesivir, 1 mg | <1% | 30 | $17K |
| 90837 | Psychotherapy session, about an hour | <1% | 140 | $16K |
| 95115 | <1% | 2,500 | $16K | |
| 64643 | <1% | 348 | $16K | |
| 94060 | <1% | 467 | $16K | |
| 90686 | <1% | 1,295 | $15K | |
| 95251 | <1% | 771 | $15K | |
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring | <1% | 34 | $15K |
| 81002 | <1% | 5,817 | $15K | |
| 59025 | Fetal non-stress test | <1% | 516 | $14K |
| 99253 | <1% | 176 | $14K | |
| 82570 | <1% | 2,390 | $14K | |
| 99442 | <1% | 616 | $14K | |
| 99441 | <1% | 939 | $13K | |
| 95806 | <1% | 223 | $13K | |
| 99078 | <1% | 473 | $13K | |
| 91320 | <1% | 113 | $12K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,843 | $12K |
| 82044 | <1% | 1,859 | $11K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 165 | $10K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,798 | $10K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,107 | $10K |
| 94664 | <1% | 899 | $9K | |
| 99335 | <1% | 276 | $9K | |
| 99224 | <1% | 291 | $8K | |
| 76857 | <1% | 264 | $8K | |
| 85018 | <1% | 2,765 | $7K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 615 | $7K |
| 17110 | <1% | 79 | $6K | |
| 96160 | <1% | 689 | $6K | |
| 95812 | <1% | 26 | $6K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 285 | $5K |
| 94729 | <1% | 421 | $5K | |
| 96127 | <1% | 688 | $5K | |
| 99462 | <1% | 150 | $5K | |
| 99236 | Prolong inpt eval add15 m | <1% | 24 | $5K |
| 99443 | <1% | 152 | $5K | |
| 94726 | <1% | 366 | $5K | |
| 82043 | <1% | 763 | $5K | |
| 80305 | <1% | 542 | $4K | |
| 95957 | <1% | 57 | $4K | |
| 93750 | <1% | 172 | $4K | |
| 76825 | <1% | 16 | $4K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 49 | $4K |
| 90480 | <1% | 112 | $4K | |
| 82947 | <1% | 1,217 | $3K | |
| 96161 | <1% | 398 | $3K | |
| 95718 | <1% | 30 | $3K | |
| 99326 | <1% | 28 | $3K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 281 | $3K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 23 | $3K |
| 0002A | <1% | 58 | $3K | |
| 81025 | <1% | 425 | $3K | |
| 99354 | <1% | 29 | $2K | |
| 54150 | <1% | 27 | $2K | |
| 0001A | <1% | 57 | $2K | |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | <1% | 99 | $2K |
| 00731 | <1% | 14 | $2K | |
| 93971 | <1% | 208 | $2K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 12 | $2K |
| 99221 | <1% | 41 | $2K | |
| 99497 | <1% | 82 | $2K | |
| 51798 | <1% | 491 | $2K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 48 | $2K |
| 99307 | <1% | 246 | $2K | |
| 93970 | <1% | 103 | $2K | |
| 0004A | <1% | 43 | $2K | |
| 54162 | <1% | 17 | $2K | |
| 99381 | <1% | 27 | $2K | |
| 90715 | <1% | 41 | $2K | |
| 99325 | <1% | 22 | $1K | |
| 99401 | <1% | 47 | $1K | |
| 99385 | <1% | 13 | $1K | |
| 95811 | <1% | 12 | $1K | |
| 92136 | <1% | 57 | $1K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 83 | $1K |
| 90656 | <1% | 81 | $1K | |
| 92002 | <1% | 23 | $1K | |
| 97804 | <1% | 38 | $1K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 34 | $903.91 |
| 93922 | <1% | 181 | $764.59 | |
| 54450 | <1% | 12 | $715.32 | |
| J7050 | Infusion, normal saline solution, 250 cc | <1% | 1,044 | $706.07 |
| 97597 | <1% | 72 | $625.95 | |
| 99334 | <1% | 18 | $581.83 | |
| T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | <1% | 77 | $535.07 |
| 0054A | <1% | 12 | $504.80 | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 15 | $372.92 |
| 94618 | <1% | 25 | $361.05 | |
| G9009 | Coordinated care fee, risk adjusted maintenance, level 3 | <1% | 13 | $326.30 |
| 96040 | <1% | 12 | $322.26 | |
| 69210 | <1% | 17 | $313.57 | |
| 85027 | <1% | 82 | $298.26 | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 13 | $258.62 |
| 93926 | <1% | 26 | $215.34 | |
| 93925 | <1% | 14 | $199.04 | |
| 93018 | <1% | 26 | $179.54 | |
| 99406 | <1% | 28 | $99.14 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 14 | $85.66 |
| 82962 | <1% | 38 | $46.65 | |
| 98968 | <1% | 27 | $34.97 | |
| 3074F | <1% | 5,470 | $24.94 | |
| 93297 | <1% | 13 | $19.21 | |
| 3078F | <1% | 4,416 | $18.62 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 12 | $14.86 |
| 3079F | <1% | 473 | $1.90 | |
| 3044F | <1% | 120 | $0.84 | |
| 3080F | <1% | 12 | $0.10 | |
| 3075F | <1% | 24 | $0.07 | |
| 3077F | <1% | 26 | $0.05 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 12 | $0.00 |
| 36416 | 0% | 253 | $0.00 | |
| 99339 | 0% | 93 | $0.00 | |
| T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | 0% | 55 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 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 officialLAWRENCE, KRISTI (DIRECTOR-PROVIDER ENROLLMENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.