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

Prisma Health University Medical Group

Prisma Health University Medical Group was paid $172.15M by Medicaid between Jan 2018 and Dec 2024, across 297 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 22% of everything it billed.

33Billing provider infoPRISMA HEALTH UNIVERSITY MEDICAL GROUP
GREENVILLE, SC 29607
33aNPI1295763217assigned 06/29/2006
33bProvider typeInternal Medicine Physician
28Total paid$172.15M
24GClaims3,035,472
24DCodes billed297
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Internal Medicine Physician providers in South Carolina

Rank by total paid#1 of 273
Median peer was paid$19K
This provider vs. median9,044×

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

$0$1.0M$2.0M$3.0M2018201920202021202220232024
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
2018433,032$22.87M
2019411,524$22.76M
2020366,215$21.28M
2021444,347$25.42M
2022468,899$27.72M
2023464,681$27.60M
2024incomplete446,774$24.51M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
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 22% 521,591 494,897 $37.19M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 20% 672,376 630,263 $33.86M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 8.6% 181,478 178,547 $14.83M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 4.1% 68,610 63,796 $7.06M
59409 Vaginal delivery only (with or without episiotomy and/or forceps) 4.0% 6,405 5,888 $6.92M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 3.9% 59,213 57,814 $6.64M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 3.4% 129,841 127,906 $5.89M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3.1% 74,791 70,077 $5.36M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3.0% 65,459 64,906 $5.11M
90460 Immunization administration through 18 years of age via any route, first or only component 2.3% 140,066 138,088 $3.97M
99244 Office or other outpatient consultation, moderate to high complexity 2.1% 23,042 22,817 $3.63M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up 1.6% 30,638 27,754 $2.71M
285 more codes
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1.5% 32,407 $2.50M
G9153 Mapcp demonstration - physician incentive pool 1.3% 40,768 $2.19M
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed 1.1% 12,748 $1.91M
76819 Fetal biophysical profile; without non-stress testing 1.1% 27,009 $1.84M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 17,540 $1.60M
99203 Doctor's office visit, new patient (routine) <1% 20,711 $1.58M
99243 <1% 14,293 $1.52M
99232 Hospital visit by a doctor, follow-up day <1% 33,129 $1.50M
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study <1% 8,733 $1.35M
95812 <1% 5,913 $1.30M
59514 <1% 1,155 $1.11M
99204 Doctor's office visit, new patient (more involved) <1% 8,892 $1.03M
90461 <1% 42,092 $863K
87428 <1% 13,118 $812K
99238 Hospital discharge day management, 30 minutes or less <1% 13,068 $771K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 9,097 $760K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 7,310 $582K
76820 <1% 14,262 $536K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 39,121 $528K
99080 <1% 2,560 $511K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 61,162 $436K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 4,203 $431K
76801 <1% 4,163 $424K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 5,050 $420K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 3,791 $420K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 4,525 $419K
90834 Psychotherapy session, about 45 minutes <1% 5,177 $393K
99460 <1% 5,059 $389K
59025 Fetal non-stress test <1% 14,780 $365K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 14,091 $352K
93320 <1% 8,683 $351K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 3,573 $341K
99233 Hospital visit by a doctor, follow-up day (complex) <1% 4,341 $322K
93304 <1% 3,370 $304K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 1,549 $284K
93325 <1% 16,079 $283K
99188 <1% 19,046 $280K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 59,469 $270K
99223 Prolong inpt eval add15 m <1% 2,198 $269K
94010 <1% 10,708 $255K
90837 Psychotherapy session, about an hour <1% 1,780 $235K
93000 <1% 16,267 $232K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 16,885 $230K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 7,542 $218K
95782 <1% 2,033 $206K
99222 Initial hospital care, per day, moderate complexity <1% 2,032 $200K
01922 <1% 935 $171K
J0585 Injection, onabotulinumtoxina, 1 unit <1% 287 $164K
99245 <1% 779 $164K
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia <1% 1,991 $156K
90792 Psychiatric diagnostic evaluation with medical services <1% 1,498 $143K
J1050 Injection, medroxyprogesterone acetate, 1 mg <1% 2,066 $142K
59430 <1% 1,493 $141K
0001A <1% 3,587 $138K
0002A <1% 3,404 $135K
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 585 $123K
31575 <1% 1,913 $121K
92015 Determination of refractive state <1% 6,961 $120K
83036 Hemoglobin; glycosylated (A1C) <1% 14,928 $120K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 1,967 $116K
99242 <1% 1,424 $112K
99051 <1% 9,704 $112K
99239 Hospital discharge day management, more than 30 minutes <1% 1,406 $111K
81002 <1% 34,338 $110K
54150 <1% 1,421 $109K
99309 Subsequent nursing facility care, per day, low to moderate complexity <1% 4,787 $109K
99221 <1% 1,332 $108K
96127 <1% 16,276 $107K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 3,106 $103K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) <1% 2,461 $101K
36415 Collection of venous blood by venipuncture <1% 37,168 $92K
97803 <1% 3,750 $85K
93321 <1% 4,940 $82K
73100 <1% 3,244 $82K
92567 <1% 4,865 $75K
99205 Prolong outpt/office vis <1% 550 $73K
99220 <1% 455 $68K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 1,339 $67K
20610 <1% 2,731 $67K
81003 <1% 24,939 $64K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 895 $64K
92588 <1% 1,194 $62K
A4590 Special casting material (e.g., fiberglass) <1% 2,385 $60K
99462 <1% 1,776 $58K
90791 Psychiatric diagnostic evaluation <1% 324 $57K
97802 <1% 1,210 $50K
90832 Psychotherapy session, about 30 minutes <1% 1,352 $50K
99078 <1% 1,622 $49K
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years <1% 117 $47K
85018 <1% 18,232 $44K
76818 <1% 523 $44K
82947 <1% 12,912 $43K
99219 <1% 433 $42K
11750 <1% 397 $42K
96160 <1% 3,266 $39K
95811 <1% 428 $38K
99235 <1% 282 $38K
72082 <1% 593 $36K
92557 <1% 1,106 $36K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 600 $35K
76821 <1% 512 $34K
99417 Prolong home eval add 15m <1% 1,111 $34K
H0004 Behavioral health counseling and therapy, per 15 minutes <1% 690 $32K
99441 <1% 2,191 $32K
90677 <1% 1,931 $31K
92579 <1% 743 $31K
73070 <1% 1,337 $29K
99442 <1% 1,247 $28K
95117 <1% 3,747 $27K
92340 Fitting of spectacles, except for aphakia; monofocal <1% 1,239 $26K
73630 <1% 1,227 $24K
31622 <1% 483 $24K
0071A <1% 573 $23K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 2,643 $23K
92587 <1% 486 $23K
81025 <1% 3,470 $23K
17110 <1% 341 $21K
0072A <1% 516 $21K
87807 <1% 1,796 $20K
90686 <1% 22,456 $20K
99308 Subsequent nursing facility care, per day, straightforward <1% 1,231 $19K
93296 <1% 1,891 $17K
95819 <1% 224 $17K
G9008 Coordinated care fee, physician coordinated care oversight services <1% 229 $16K
G9011 Coordinated care fee, risk adjusted maintenance, level 5 <1% 186 $16K
99174 <1% 3,028 $16K
31231 <1% 114 $15K
90847 Family psychotherapy with the patient present, 50 minutes <1% 111 $15K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 2,112 $14K
72081 <1% 357 $13K
72170 <1% 604 $13K
51784 <1% 226 $12K
90697 <1% 1,404 $11K
73560 <1% 424 $11K
95951 <1% 73 $10K
42975 <1% 122 $10K
93297 <1% 739 $10K
0004A <1% 242 $10K
93971 <1% 802 $10K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 703 $9K
11721 <1% 308 $9K
99234 <1% 79 $9K
92201 <1% 426 $9K
29075 <1% 138 $9K
64615 <1% 101 $8K
92002 <1% 184 $8K
99255 <1% 38 $8K
54161 <1% 68 $8K
51798 <1% 1,107 $8K
95806 <1% 239 $8K
J0475 Injection, baclofen, 10 mg <1% 18 $8K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,017 $8K
73090 <1% 326 $7K
95251 <1% 446 $7K
99381 <1% 79 $7K
99217 <1% 121 $7K
80048 Basic metabolic panel (calcium, ionized) <1% 995 $7K
96161 <1% 992 $6K
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg <1% 1,465 $6K
93295 <1% 316 $6K
11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm <1% 261 $5K
76981 <1% 111 $5K
H0002 Behavioral health screening to determine eligibility for admission to treatment program <1% 223 $5K
A4627 Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler <1% 171 $5K
99292 <1% 34 $5K
92504 <1% 334 $5K
87081 <1% 828 $5K
G2066 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results <1% 548 $5K
99443 <1% 156 $5K
76825 <1% 28 $5K
73610 <1% 246 $5K
31526 <1% 67 $5K
99253 <1% 39 $5K
95886 <1% 97 $4K
74018 <1% 315 $4K
92551 <1% 891 $4K
99241 <1% 105 $4K
11981 <1% 82 $4K
95816 <1% 78 $4K
95720 <1% 19 $4K
98966 <1% 318 $4K
99170 <1% 38 $4K
92552 <1% 268 $3K
77073 <1% 123 $3K
73564 <1% 176 $3K
29065 <1% 52 $3K
69210 <1% 118 $3K
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% 29 $3K
99310 Prolong nursin fac eval 15m <1% 91 $3K
99236 Prolong inpt eval add15 m <1% 15 $3K
73590 <1% 133 $3K
93298 <1% 229 $3K
80076 <1% 392 $2K
87210 <1% 505 $2K
95885 <1% 74 $2K
93308 <1% 48 $2K
93922 <1% 440 $2K
76830 Ultrasound, transvaginal <1% 26 $2K
94375 <1% 68 $2K
93227 <1% 102 $2K
77067 Screening mammography, bilateral, including computer-aided detection <1% 25 $2K
93016 <1% 158 $2K
T1023 Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter <1% 169 $2K
0031A <1% 61 $2K
95012 <1% 134 $2K
90715 <1% 545 $1K
90656 <1% 2,803 $1K
51741 <1% 126 $1K
73030 <1% 139 $1K
97597 <1% 158 $1K
90682 <1% 28 $1K
62370 <1% 40 $1K
93925 <1% 88 $1K
42830 <1% 13 $1K
94729 <1% 70 $1K
93018 <1% 158 $1K
99383 <1% 12 $1K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 37 $1K
93294 <1% 107 $953.75
90651 <1% 712 $920.88
92555 <1% 104 $920.53
93970 <1% 76 $877.66
99306 Prolong nursin fac eval 15m <1% 15 $833.84
99318 <1% 19 $781.52
V2784 Lens, polycarbonate or equal, any index, per lens <1% 26 $777.42
92582 <1% 20 $777.27
91200 <1% 64 $746.86
20611 <1% 33 $728.18
93272 <1% 46 $698.35
73000 <1% 28 $668.64
73502 <1% 42 $656.68
11102 <1% 12 $635.40
93886 <1% 14 $607.48
V2020 Frames, purchases <1% 14 $590.10
58300 <1% 12 $579.21
17250 <1% 13 $552.85
96380 <1% 29 $537.82
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 17 $526.98
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg <1% 65 $512.33
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 15 $505.11
93280 <1% 27 $462.18
99307 <1% 41 $457.96
94060 <1% 29 $406.48
93228 <1% 43 $380.15
71046 Radiologic examination, chest; 2 views <1% 28 $335.97
85027 <1% 65 $324.78
73140 <1% 19 $303.69
94727 <1% 29 $298.61
93880 <1% 26 $283.76
99406 <1% 27 $263.13
92133 <1% 13 $260.39
83986 <1% 91 $251.37
J1040 Injection, methylprednisolone acetate, 80 mg <1% 36 $234.80
73562 <1% 14 $180.24
3074F <1% 22,159 $148.17
3078F <1% 20,126 $136.22
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 13 $127.94
80047 <1% 12 $110.39
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 12 $103.45
90680 <1% 2,986 $100.90
93979 <1% 14 $87.50
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 152 $66.76
Q0111 Wet mounts, including preparations of vaginal, cervical or skin specimens <1% 12 $61.30
99152 <1% 12 $61.14
81001 <1% 40 $40.08
A9585 Injection, gadobutrol, 0.1 ml <1% 12 $20.85
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 13 $6.10
36416 <1% 394 $2.69
90685 <1% 659 $1.33
90619 <1% 86 $0.41
3079F <1% 102 $0.33
3044F <1% 49 $0.24
90381 <1% 27 $0.11
90670 <1% 7,411 $0.09
3075F <1% 27 $0.05
90698 <1% 4,925 $0.04
90633 <1% 1,020 $0.03
90744 0% 742 $0.00
90696 0% 26 $0.00
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) 0% 17 $0.00
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% 279 $0.00
90734 0% 168 $0.00
G1004 Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program 0% 45 $0.00
90672 0% 14 $0.00
3077F 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 OF PROVIDER ENROLLMENT)
Same official

Other billing entities under LAWRENCE, KRISTI

Full network →
ProviderLocationPaid
Prisma Health Medical Group-MidlandsColumbia, SC$77.82M
Prisma Health University Medical GroupGreenville, SC$15.98M
Prisma Health - Blount Memorial Hospital INC.Maryville, TN$14.75M
Prisma Health Medical Group-MidlandsColumbia, SC$8.70M
Prisma Health University Medical GroupEasley, SC$4.70M
Blount Memorial Physician Group, INC.Alcoa, TN$4.21M
Prisma Health Medical Group-MidlandsSumter, SC$3.66M
Prisma Health University Medical GroupGreenville, SC$2.07M
Prisma Health University Medical GroupColumbia, SC$581K
Prisma Health University Medical GroupTaylors, SC$412K
Prisma Health Medical Group-MidlandsColumbia, SC$263K
Prisma Health - Blount Memorial Hospital INC.Maryville, TN$233K
Prisma Health University Medical GroupGreenville, SC$59K
Prisma Health University Medical GroupGreenville, SC$21K
Prisma Health Urgent Care of South Carolina, PCGreenville, SC$19K
Prisma Health University Medical GroupColumbia, SC$19K
Prisma Health University Medical GroupGreenville, SC$17K
Prisma Health - Blount Memorial Hospital INC.Maryville, TN$10K
Prisma Health University Medical GroupEasley, SC$4K
Prisma Health Medical Group-MidlandsSumter, SC$3K

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