Prisma Health University Medical Group
Prisma Health University Medical Group was paid $15.98M by Medicaid between Jan 2018 and Dec 2024, across 6 billing codes. Its largest line is T1023, Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter — 63% of everything it billed.
GREENVILLE, SC 29615
Next to other Developmental - Behavioral Pediatrics Physician providers in South Carolina
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.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 9,650 | $2.41M | |
| 2019 | 10,254 | $2.41M | |
| 2020 | 10,535 | $2.27M | |
| 2021 | 11,314 | $2.41M | |
| 2022 | 11,894 | $2.60M | |
| 2023 | 11,616 | $2.63M | |
| 2024incomplete | 5,955 | $1.25M |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | 63% | 59,529 | 58,597 | $10.02M |
| T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | 37% | 9,701 | 8,117 | $5.91M |
| G9004 | Coordinated care fee, risk adjusted low, initial | <1% | 1,301 | 1,240 | $36K |
| G9011 | Coordinated care fee, risk adjusted maintenance, level 5 | <1% | 146 | 87 | $9K |
| 3074F | <1% | 280 | 280 | $2.68 | |
| 3078F | <1% | 261 | 261 | $2.61 |
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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.