Prisma Health Medical Group-Midlands

Prisma Health Medical Group-Midlands was paid $5.90M by Medicaid between Jul 2019 and Dec 2024, across 3 billing codes. Its largest line is T1024, Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter — 62% of everything it billed.

33Billing provider infoPRISMA HEALTH MEDICAL GROUP-MIDLANDS
COLUMBIA, SC 29203

33aNPI1457848848assigned 04/20/2018

33bProvider typeDevelopmental - Behavioral Pediatrics Physician

28Total paid$5.90M

24GClaims18,659

24DCodes billed3

24AFirst – last monthJul 2019 – Dec 2024

Compared with peers

Next to other Developmental - Behavioral Pediatrics Physician providers in South Carolina

Rank by total paid#2 of 6

Median peer was paid$579K

This provider vs. median10×

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.

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
2019	1,781	$691K
2020	4,190	$1.14M
2021	3,654	$1.19M
2022	3,942	$1.34M
2023	3,425	$1.07M
2024incomplete	1,667	$469K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	62%	6,374	5,689	$3.68M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	37%	11,724	10,993	$2.20M
G9004	Coordinated care fee, risk adjusted low, initial	<1%	561	405	$16K

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 officialELLIS, JAMES (CHIEF INTEGRATION OFFICER)

Same official

Other billing entities under ELLIS, JAMES

Full network →

Provider	Location	Paid
Southwest Mississippi Mental Health Mental Retardation Commission	Mccomb, MS	$5.03M
Prisma Health Medical Group-Midlands	Columbia, SC	$2.49M
Prisma Health Medical Group-Midlands	Columbia, SC	$17K

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