Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $9.32M by Medicaid between Oct 2018 and Dec 2024, across 216 billing codes. Its largest line is 36415, Collection of venous blood by venipuncture — 19% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
EASLEY, SC 29640
EASLEY, SC 29640
33aNPI1639656713assigned 07/23/2018
33bProvider typeGeneral Acute Care Hospital
28Total paid$9.32M
24GClaims431,883
24DCodes billed216
24AFirst – last monthOct 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#34 of 115
Median peer was paid$2.47M
This provider vs. median3.8×
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 | 9,706 | $264K | |
| 2019 | 71,800 | $1.39M | |
| 2020 | 70,777 | $1.46M | |
| 2021 | 79,968 | $1.73M | |
| 2022 | 72,393 | $1.65M | |
| 2023 | 67,502 | $1.65M | |
| 2024incomplete | 59,737 | $1.18M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 36415 | Collection of venous blood by venipuncture | 19% | 23,590 | 18,415 | $1.77M |
| 80053 | Comprehensive metabolic panel | 9.3% | 20,769 | 18,848 | $867K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 7.8% | 20,172 | 19,183 | $724K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 5.5% | 4,861 | 4,742 | $517K |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 4.4% | 4,933 | 4,747 | $412K |
| 80048 | Basic metabolic panel (calcium, ionized) | 2.9% | 9,540 | 7,905 | $272K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2.7% | 2,911 | 2,791 | $256K |
| 86850 | 2.7% | 1,843 | 1,721 | $253K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.5% | 6,227 | 3,927 | $237K |
| 81025 | 2.5% | 7,999 | 7,531 | $237K | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 2.5% | 7,588 | 6,934 | $234K |
| 96361 | Intravenous infusion, hydration; each additional hour | 2.5% | 6,462 | 5,641 | $231K |
204 more codes
| 76830 | Ultrasound, transvaginal | 2.4% | 737 | $220K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.5% | 1,140 | $140K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1.4% | 468 | $134K |
| 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% | 2,211 | $125K |
| 87086 | Culture, bacterial; quantitative colony count, urine | 1.2% | 7,997 | $109K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 1.2% | 5,011 | $108K |
| 81001 | 1.1% | 11,084 | $102K | |
| 99284 | Emergency room visit (serious) | 1.0% | 12,982 | $97K |
| 87081 | 1.0% | 2,594 | $94K | |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 111 | $92K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 5,449 | $90K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 618 | $88K |
| 73610 | <1% | 1,475 | $84K | |
| 87070 | <1% | 1,035 | $83K | |
| 87077 | <1% | 3,639 | $81K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 2,001 | $78K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,388 | $72K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 3,023 | $71K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 425 | $71K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 3,055 | $70K |
| 73130 | <1% | 1,016 | $66K | |
| 73630 | <1% | 1,678 | $64K | |
| 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% | 854 | $63K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 3,420 | $61K |
| 81003 | <1% | 3,203 | $53K | |
| 73110 | <1% | 838 | $50K | |
| 73564 | <1% | 1,467 | $49K | |
| 99285 | Emergency room visit (most serious) | <1% | 11,364 | $42K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 1,162 | $41K |
| 82565 | <1% | 309 | $36K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 960 | $36K |
| 71045 | Radiologic examination, chest; single view | <1% | 5,517 | $36K |
| 86900 | <1% | 2,106 | $35K | |
| 73030 | <1% | 993 | $32K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 531 | $31K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 1,268 | $31K |
| 93971 | <1% | 241 | $27K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,047 | $27K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 28,201 | $26K |
| 84702 | <1% | 2,068 | $25K | |
| 71250 | <1% | 126 | $23K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 1,962 | $23K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 453 | $22K |
| 72100 | <1% | 979 | $22K | |
| 87210 | <1% | 819 | $21K | |
| 74018 | <1% | 657 | $19K | |
| 97597 | <1% | 503 | $19K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 201 | $18K |
| 76642 | <1% | 524 | $16K | |
| 80061 | Lipid panel | <1% | 3,759 | $13K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 9,424 | $12K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 7,450 | $11K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 1,069 | $11K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 581 | $10K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 6,143 | $10K |
| 82950 | <1% | 1,196 | $9K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,474 | $8K |
| 73090 | <1% | 135 | $8K | |
| 73080 | <1% | 127 | $8K | |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 5,678 | $7K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 956 | $7K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 5,728 | $7K |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | <1% | 1,255 | $7K |
| 96376 | <1% | 2,020 | $7K | |
| 86780 | <1% | 1,464 | $7K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 2,470 | $7K |
| 80076 | <1% | 1,669 | $7K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 528 | $6K |
| 76770 | <1% | 73 | $6K | |
| 84439 | <1% | 1,031 | $5K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,931 | $5K |
| G0378 | Hospital observation service, per hour | <1% | 1,675 | $4K |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 786 | $4K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 917 | $4K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 89 | $4K |
| 73502 | <1% | 175 | $4K | |
| 82607 | <1% | 730 | $4K | |
| 82728 | <1% | 558 | $4K | |
| 82105 | <1% | 283 | $3K | |
| 83735 | <1% | 4,595 | $3K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 6,754 | $3K |
| 96367 | <1% | 144 | $3K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 5,811 | $3K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 106 | $3K |
| 84484 | <1% | 6,542 | $3K | |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | <1% | 18 | $3K |
| 93970 | <1% | 12 | $2K | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 6,866 | $2K |
| 93017 | <1% | 40 | $2K | |
| 82043 | <1% | 294 | $2K | |
| 87807 | <1% | 82 | $2K | |
| 73140 | <1% | 26 | $2K | |
| 83605 | <1% | 2,867 | $2K | |
| 76536 | <1% | 13 | $2K | |
| J3490 | Unclassified drugs | <1% | 5,724 | $2K |
| 74022 | <1% | 109 | $2K | |
| 85379 | <1% | 1,473 | $1K | |
| 73590 | <1% | 85 | $1K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 97 | $1K |
| 87205 | <1% | 757 | $1K | |
| 93976 | <1% | 1,136 | $1K | |
| 82550 | <1% | 560 | $1K | |
| J3475 | Injection, magnesium sulfate, per 500 mg | <1% | 868 | $1K |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | <1% | 333 | $1K |
| 85027 | <1% | 2,666 | $1K | |
| 88304 | <1% | 38 | $1K | |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 1,996 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 190 | $1K |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | <1% | 837 | $1K |
| 85014 | <1% | 117 | $987.32 | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 12 | $958.92 |
| 87186 | <1% | 2,793 | $883.59 | |
| 12001 | <1% | 14 | $812.00 | |
| 82570 | <1% | 418 | $805.19 | |
| 86803 | <1% | 495 | $706.47 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 2,172 | $650.75 |
| J2060 | Injection, lorazepam, 2 mg | <1% | 277 | $646.98 |
| 86140 | <1% | 1,926 | $621.15 | |
| C1894 | Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser | <1% | 13 | $516.86 |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 636 | $507.81 |
| 80074 | <1% | 12 | $506.84 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 2,285 | $504.65 |
| 76775 | <1% | 14 | $493.36 | |
| 83880 | <1% | 1,962 | $446.41 | |
| 84156 | <1% | 83 | $442.00 | |
| 85007 | <1% | 598 | $423.17 | |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | <1% | 4,030 | $354.50 |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 148 | $343.10 |
| J1650 | Injection, enoxaparin sodium, 10 mg | <1% | 604 | $329.85 |
| 86592 | <1% | 45 | $317.92 | |
| 84145 | <1% | 991 | $280.11 | |
| J2550 | Injection, promethazine hcl, up to 50 mg | <1% | 370 | $243.51 |
| 76942 | <1% | 60 | $236.45 | |
| 82247 | <1% | 133 | $223.94 | |
| 82140 | <1% | 27 | $220.82 | |
| 82040 | <1% | 39 | $190.84 | |
| 85018 | <1% | 795 | $164.03 | |
| 84146 | <1% | 27 | $163.36 | |
| 86762 | <1% | 886 | $124.91 | |
| 85610 | <1% | 2,255 | $121.10 | |
| 83540 | <1% | 427 | $113.65 | |
| J1815 | Injection, insulin, per 5 units | <1% | 700 | $82.79 |
| 83690 | <1% | 5,820 | $72.25 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 1,003 | $64.12 |
| 90715 | <1% | 250 | $33.90 | |
| 85651 | <1% | 651 | $24.95 | |
| 97162 | <1% | 157 | $24.81 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 1,662 | $20.88 |
| 84132 | <1% | 12 | $16.31 | |
| 84550 | <1% | 26 | $14.45 | |
| 82077 | <1% | 1,357 | $13.82 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 2,737 | $2.38 |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 1,861 | $1.26 |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 788 | $0.47 |
| 86901 | 0% | 2,105 | $0.00 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 0% | 576 | $0.00 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 3,300 | $0.00 |
| 85730 | 0% | 1,033 | $0.00 | |
| 87340 | 0% | 1,091 | $0.00 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | 0% | 506 | $0.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 2,136 | $0.00 |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | 0% | 72 | $0.00 |
| 85652 | 0% | 536 | $0.00 | |
| 82677 | 0% | 32 | $0.00 | |
| 87040 | 0% | 1,402 | $0.00 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 0% | 83 | $0.00 |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | 0% | 234 | $0.00 |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 0% | 13 | $0.00 |
| 90870 | 0% | 37 | $0.00 | |
| 82746 | 0% | 25 | $0.00 | |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 0% | 13 | $0.00 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 0% | 39 | $0.00 |
| 86580 | 0% | 45 | $0.00 | |
| 70498 | 0% | 25 | $0.00 | |
| 76801 | 0% | 44 | $0.00 | |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | 0% | 18 | $0.00 |
| 94761 | 0% | 18 | $0.00 | |
| 70496 | 0% | 13 | $0.00 | |
| 82803 | 0% | 13 | $0.00 | |
| 84100 | 0% | 1,323 | $0.00 | |
| 80143 | 0% | 494 | $0.00 | |
| 80179 | 0% | 410 | $0.00 | |
| 86336 | 0% | 32 | $0.00 | |
| J1644 | Injection, heparin sodium, per 1000 units | 0% | 1,336 | $0.00 |
| 76000 | 0% | 100 | $0.00 | |
| 82805 | 0% | 178 | $0.00 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 150 | $0.00 |
| J0688 | Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg | 0% | 14 | $0.00 |
| 84466 | 0% | 411 | $0.00 | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 0% | 22 | $0.00 |
| 82248 | 0% | 163 | $0.00 | |
| J1596 | Injection, glycopyrrolate, 0.1 mg | 0% | 151 | $0.00 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 0% | 154 | $0.00 |
| 97116 | 0% | 89 | $0.00 | |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 0% | 148 | $0.00 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 0% | 16 | $0.00 |
| C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | 0% | 32 | $0.00 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 0% | 20 | $0.00 |
| 84403 | 0% | 13 | $0.00 | |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 0% | 203 | $0.00 |
| 86038 | 0% | 13 | $0.00 | |
| 36600 | 0% | 31 | $0.00 | |
| J1171 | Injection, hydromorphone, 0.1 mg | 0% | 52 | $0.00 |
| 51701 | 0% | 13 | $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.