Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $8.30M by Medicaid between Jan 2018 and Dec 2024, across 203 billing codes. Its largest line is 80053, Comprehensive metabolic panel — 12% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
SIMPSONVILLE, SC 29681
SIMPSONVILLE, SC 29681
33aNPI1447706569assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$8.30M
24GClaims376,262
24DCodes billed203
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#39 of 115
Median peer was paid$2.47M
This provider vs. median3.4×
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 | 40,003 | $875K | |
| 2019 | 46,304 | $882K | |
| 2020 | 39,584 | $855K | |
| 2021 | 55,613 | $1.30M | |
| 2022 | 66,746 | $1.63M | |
| 2023 | 67,813 | $1.59M | |
| 2024incomplete | 60,199 | $1.17M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 80053 | Comprehensive metabolic panel | 12% | 15,514 | 13,916 | $1.01M |
| 36415 | Collection of venous blood by venipuncture | 8.1% | 10,019 | 8,343 | $676K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 7.0% | 18,371 | 17,554 | $577K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 5.7% | 4,907 | 4,769 | $472K |
| 80048 | Basic metabolic panel (calcium, ionized) | 5.0% | 7,635 | 6,730 | $419K |
| 87081 | 3.9% | 5,397 | 5,316 | $327K | |
| 81025 | 3.9% | 9,388 | 8,926 | $322K | |
| 86850 | 3.6% | 1,778 | 1,630 | $303K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 3.3% | 3,111 | 2,616 | $273K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 2.9% | 3,175 | 3,048 | $242K |
| 96361 | Intravenous infusion, hydration; each additional hour | 2.6% | 6,741 | 5,591 | $212K |
| 76830 | Ultrasound, transvaginal | 2.0% | 1,538 | 1,497 | $169K |
191 more codes
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 1.9% | 7,322 | $161K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.8% | 1,267 | $153K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.8% | 5,339 | $150K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.8% | 3,482 | $146K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 1.5% | 7,136 | $124K |
| 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 | 1.3% | 2,928 | $107K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | 1.3% | 3,355 | $106K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 1.3% | 1,410 | $105K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 1.1% | 4,788 | $92K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 1.1% | 795 | $92K |
| 71046 | Radiologic examination, chest; 2 views | 1.1% | 5,017 | $88K |
| 87210 | <1% | 3,199 | $81K | |
| 87077 | <1% | 2,749 | $77K | |
| 99284 | Emergency room visit (serious) | <1% | 10,830 | $77K |
| 87428 | <1% | 1,308 | $77K | |
| 81001 | <1% | 10,604 | $73K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 2,039 | $70K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 2,433 | $66K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 1,044 | $65K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 1,100 | $61K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 2,270 | $59K |
| 81003 | <1% | 4,899 | $56K | |
| 99285 | Emergency room visit (most serious) | <1% | 10,323 | $50K |
| 87400 | <1% | 642 | $48K | |
| 73610 | <1% | 1,034 | $46K | |
| 73130 | <1% | 473 | $43K | |
| 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% | 474 | $41K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 945 | $40K |
| 85610 | <1% | 2,690 | $40K | |
| 86900 | <1% | 1,965 | $39K | |
| 73630 | <1% | 1,003 | $36K | |
| 86780 | <1% | 2,431 | $35K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 625 | $35K |
| 82565 | <1% | 222 | $34K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 2,219 | $34K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 37 | $30K |
| 84702 | <1% | 1,726 | $30K | |
| 71045 | Radiologic examination, chest; single view | <1% | 4,557 | $30K |
| 71250 | <1% | 148 | $29K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 1,204 | $28K |
| 82950 | <1% | 1,288 | $27K | |
| 73564 | <1% | 784 | $25K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 23,347 | $24K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 242 | $24K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 637 | $24K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 4,401 | $24K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 198 | $20K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 499 | $20K |
| 73110 | <1% | 195 | $19K | |
| 74018 | <1% | 594 | $19K | |
| 59025 | Fetal non-stress test | <1% | 453 | $19K |
| 87070 | <1% | 262 | $18K | |
| 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | <1% | 27 | $17K |
| 83655 | <1% | 907 | $17K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 8,638 | $14K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 321 | $14K |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 5,117 | $14K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 581 | $11K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 3,802 | $11K |
| 73030 | <1% | 367 | $10K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 5,318 | $9K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 664 | $9K |
| 72100 | <1% | 336 | $8K | |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 1,353 | $7K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,237 | $6K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 54 | $6K |
| 76801 | <1% | 537 | $6K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 26 | $6K |
| 93017 | <1% | 106 | $6K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 71 | $5K |
| 80076 | <1% | 1,209 | $5K | |
| G0378 | Hospital observation service, per hour | <1% | 1,505 | $5K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 69 | $5K |
| 85027 | <1% | 3,475 | $4K | |
| 80061 | Lipid panel | <1% | 1,766 | $4K |
| 83001 | <1% | 106 | $4K | |
| 85018 | <1% | 1,526 | $4K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 424 | $4K |
| 84484 | <1% | 4,804 | $4K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 206 | $4K |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | <1% | 29 | $3K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | <1% | 111 | $3K |
| 82728 | <1% | 223 | $2K | |
| 96376 | <1% | 1,921 | $2K | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 529 | $2K |
| 80047 | <1% | 115 | $2K | |
| 83986 | <1% | 30 | $2K | |
| 87807 | <1% | 301 | $2K | |
| 83690 | <1% | 5,746 | $2K | |
| 85379 | <1% | 1,478 | $2K | |
| 85007 | <1% | 537 | $2K | |
| 82105 | <1% | 126 | $2K | |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 1,885 | $2K |
| 86762 | <1% | 1,177 | $2K | |
| 83540 | <1% | 278 | $2K | |
| 82570 | <1% | 549 | $2K | |
| 86803 | <1% | 1,179 | $1K | |
| 82247 | <1% | 112 | $1K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 1,583 | $1K |
| 83735 | <1% | 3,857 | $1K | |
| 84439 | <1% | 256 | $1K | |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | <1% | 165 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 67 | $1K |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 2,082 | $1K |
| 84146 | <1% | 56 | $1K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 2,546 | $1K |
| 72040 | <1% | 27 | $1K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 269 | $980.92 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 5,558 | $931.63 |
| 74022 | <1% | 56 | $929.06 | |
| 93976 | <1% | 715 | $884.75 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 5,280 | $860.44 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 4,504 | $830.95 |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 170 | $794.35 |
| 83605 | <1% | 1,908 | $732.33 | |
| 73502 | <1% | 37 | $704.67 | |
| J1644 | Injection, heparin sodium, per 1000 units | <1% | 1,134 | $704.64 |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision | <1% | 834 | $665.11 |
| J3475 | Injection, magnesium sulfate, per 500 mg | <1% | 246 | $652.84 |
| 76775 | <1% | 12 | $600.30 | |
| 82607 | <1% | 124 | $579.41 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 1,041 | $560.13 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | <1% | 432 | $528.21 |
| 86140 | <1% | 1,774 | $509.64 | |
| 83880 | <1% | 1,715 | $426.05 | |
| J3490 | Unclassified drugs | <1% | 3,366 | $418.90 |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 6,610 | $393.25 |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 313 | $371.14 |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 55 | $360.26 |
| 82077 | <1% | 514 | $349.33 | |
| J2550 | Injection, promethazine hcl, up to 50 mg | <1% | 470 | $341.89 |
| 88141 | <1% | 17 | $331.98 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | <1% | 524 | $286.71 |
| 86787 | <1% | 749 | $246.69 | |
| 87177 | <1% | 29 | $197.46 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 1,839 | $193.26 |
| 86901 | <1% | 1,963 | $159.93 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 1,368 | $155.09 |
| 87340 | <1% | 1,394 | $152.07 | |
| 82550 | <1% | 28 | $132.17 | |
| 86308 | <1% | 13 | $125.89 | |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | <1% | 107 | $102.71 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 46 | $86.11 |
| 76000 | <1% | 12 | $83.02 | |
| 73090 | <1% | 17 | $72.35 | |
| 83020 | <1% | 186 | $51.76 | |
| 87040 | <1% | 426 | $46.42 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | <1% | 3,018 | $46.20 |
| 86317 | <1% | 111 | $37.48 | |
| 84550 | <1% | 93 | $32.04 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 2,303 | $27.49 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 4,701 | $26.04 |
| 82784 | <1% | 17 | $11.27 | |
| 87186 | <1% | 1,802 | $11.00 | |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | <1% | 698 | $7.96 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 1,039 | $5.97 |
| 84156 | <1% | 282 | $4.73 | |
| 85651 | <1% | 423 | $4.71 | |
| 84100 | 0% | 941 | $0.00 | |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 0% | 25 | $0.00 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 130 | $0.00 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 0% | 80 | $0.00 |
| 97163 | 0% | 25 | $0.00 | |
| 90715 | 0% | 58 | $0.00 | |
| 82248 | 0% | 176 | $0.00 | |
| 84145 | 0% | 161 | $0.00 | |
| 84466 | 0% | 263 | $0.00 | |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 0% | 38 | $0.00 |
| J1596 | Injection, glycopyrrolate, 0.1 mg | 0% | 155 | $0.00 |
| 80143 | 0% | 29 | $0.00 | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 0% | 37 | $0.00 |
| 94664 | 0% | 15 | $0.00 | |
| 86682 | 0% | 18 | $0.00 | |
| J1650 | Injection, enoxaparin sodium, 10 mg | 0% | 128 | $0.00 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 0% | 40 | $0.00 |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 0% | 14 | $0.00 |
| 87209 | 0% | 29 | $0.00 | |
| 73590 | 0% | 12 | $0.00 | |
| 80179 | 0% | 13 | $0.00 | |
| 85730 | 0% | 561 | $0.00 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 0% | 636 | $0.00 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 224 | $0.00 |
| 85652 | 0% | 551 | $0.00 | |
| 83615 | 0% | 76 | $0.00 | |
| 87205 | 0% | 172 | $0.00 | |
| 86704 | 0% | 109 | $0.00 | |
| J1815 | Injection, insulin, per 5 units | 0% | 55 | $0.00 |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 0% | 24 | $0.00 |
| 88304 | 0% | 13 | $0.00 | |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 30 | $0.00 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 59 | $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.