Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $83K by Medicaid between Jan 2018 and Nov 2024, across 30 billing codes. Its largest line is 36415, Collection of venous blood by venipuncture — 45% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29605
GREENVILLE, SC 29605
33aNPI1508312604assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$83K
24GClaims18,071
24DCodes billed30
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#87 of 115
Median peer was paid$2.47M
This provider vs. median0.0×
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 | 2,716 | $47K | |
| 2019 | 2,425 | $19K | |
| 2020 | 2,407 | $330.61 | |
| 2021 | 2,615 | $2K | |
| 2022 | 2,722 | $7K | |
| 2023 | 2,828 | $7K | |
| 2024incomplete | 2,358 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 36415 | Collection of venous blood by venipuncture | 45% | 389 | 382 | $38K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 23% | 486 | 481 | $19K |
| 29848 | 12% | 25 | 24 | $10K | |
| D2930 | Prefabricated stainless steel crown - primary tooth | 11% | 37 | 37 | $9K |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 5.6% | 42 | 41 | $5K |
| 81025 | 2.9% | 25 | 24 | $2K | |
| 76000 | <1% | 131 | 128 | $357.48 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 4,257 | 4,139 | $211.45 |
| 86850 | <1% | 56 | 56 | $69.61 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 932 | 904 | $39.26 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 251 | 251 | $7.39 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 0% | 1,241 | 1,199 | $0.00 |
18 more codes
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 14 | $0.00 |
| 86900 | 0% | 56 | $0.00 | |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 0% | 484 | $0.00 |
| J0735 | Injection, clonidine hydrochloride, 1 mg | 0% | 13 | $0.00 |
| D1120 | Dental cleaning, child | 0% | 24 | $0.00 |
| 86901 | 0% | 56 | $0.00 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 650 | $0.00 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 0% | 2,971 | $0.00 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 3,260 | $0.00 |
| J3490 | Unclassified drugs | 0% | 1,624 | $0.00 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 0% | 81 | $0.00 |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 105 | $0.00 |
| V2632 | Posterior chamber intraocular lens | 0% | 70 | $0.00 |
| 64721 | 0% | 29 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 582 | $0.00 |
| 85027 | 0% | 79 | $0.00 | |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 0% | 56 | $0.00 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 45 | $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 (SVP FINANCE, ENTERPRISE CONTRACTING)
| 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.