Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $1.36M by Medicaid between Jan 2018 and Nov 2024, across 32 billing codes. Its largest line is 36415, Collection of venous blood by venipuncture — 86% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29615
GREENVILLE, SC 29615
33aNPI1679029771assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$1.36M
24GClaims58,001
24DCodes billed32
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#66 of 115
Median peer was paid$2.47M
This provider vs. median0.6×
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 | 6,387 | $175K | |
| 2019 | 7,978 | $176K | |
| 2020 | 8,475 | $198K | |
| 2021 | 10,167 | $252K | |
| 2022 | 10,442 | $239K | |
| 2023 | 7,995 | $174K | |
| 2024incomplete | 6,557 | $146K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 36415 | Collection of venous blood by venipuncture | 86% | 10,987 | 6,724 | $1.16M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7.9% | 9,791 | 6,853 | $107K |
| 80048 | Basic metabolic panel (calcium, ionized) | 2.3% | 6,811 | 4,215 | $31K |
| 96375 | Therapeutic injection; each additional sequential IV push | 1.2% | 222 | 99 | $17K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 103 | 66 | $9K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 464 | 244 | $8K |
| 83735 | <1% | 1,581 | 936 | $7K | |
| 80053 | Comprehensive metabolic panel | <1% | 2,392 | 1,856 | $5K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 20 | 14 | $3K |
| 82728 | <1% | 1,575 | 1,442 | $2K | |
| 80076 | <1% | 5,156 | 3,702 | $2K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 10,084 | 6,332 | $2K |
20 more codes
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 71 | $1K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 22 | $726.48 |
| 83615 | <1% | 1,971 | $465.72 | |
| 83883 | <1% | 429 | $384.26 | |
| 82607 | <1% | 68 | $287.94 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 18 | $138.86 |
| 84165 | <1% | 573 | $99.19 | |
| 86300 | <1% | 184 | $73.71 | |
| 85027 | <1% | 467 | $65.33 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 143 | $43.95 |
| 83540 | <1% | 1,372 | $35.53 | |
| 82784 | <1% | 292 | $30.21 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 1,039 | $0.48 |
| 83521 | 0% | 126 | $0.00 | |
| 84466 | 0% | 1,374 | $0.00 | |
| 84439 | 0% | 28 | $0.00 | |
| 84550 | 0% | 132 | $0.00 | |
| 85007 | 0% | 444 | $0.00 | |
| 84100 | 0% | 42 | $0.00 | |
| 82977 | 0% | 20 | $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.