Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $3.42M by Medicaid between Jan 2018 and Nov 2024, across 52 billing codes. Its largest line is 36415, Collection of venous blood by venipuncture — 73% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29605
GREENVILLE, SC 29605
33aNPI1689129496assigned 08/22/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$3.42M
24GClaims126,590
24DCodes billed52
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#56 of 115
Median peer was paid$2.47M
This provider vs. median1.4×
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 | 17,192 | $375K | |
| 2019 | 20,314 | $434K | |
| 2020 | 18,134 | $411K | |
| 2021 | 17,338 | $480K | |
| 2022 | 17,815 | $581K | |
| 2023 | 18,107 | $573K | |
| 2024incomplete | 17,690 | $569K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 36415 | Collection of venous blood by venipuncture | 73% | 19,674 | 14,574 | $2.50M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 14% | 19,969 | 15,835 | $465K |
| 80053 | Comprehensive metabolic panel | 5.0% | 16,619 | 11,793 | $172K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.6% | 4,158 | 3,323 | $55K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.1% | 348 | 224 | $37K |
| 96361 | Intravenous infusion, hydration; each additional hour | 1.1% | 293 | 222 | $37K |
| 85007 | <1% | 8,257 | 5,651 | $22K | |
| 85027 | <1% | 21,332 | 15,200 | $21K | |
| 86850 | <1% | 2,603 | 1,765 | $20K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 267 | 200 | $19K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 632 | 438 | $14K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 256 | 184 | $11K |
40 more codes
| 96523 | <1% | 70 | $11K | |
| 86902 | <1% | 898 | $9K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 127 | $6K |
| 82728 | <1% | 4,033 | $4K | |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 117 | $3K |
| 90837 | Psychotherapy session, about an hour | <1% | 146 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 65 | $2K |
| 83020 | <1% | 1,474 | $2K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 242 | $2K |
| 36430 | <1% | 545 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 34 | $994.48 |
| 85660 | <1% | 1,277 | $739.27 | |
| 83540 | <1% | 1,928 | $642.44 | |
| 86900 | <1% | 2,823 | $593.34 | |
| 86920 | <1% | 89 | $557.12 | |
| 86923 | <1% | 402 | $370.23 | |
| 90686 | <1% | 752 | $279.61 | |
| 88112 | <1% | 79 | $123.41 | |
| 90656 | <1% | 85 | $34.10 | |
| 36591 | <1% | 40 | $30.05 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 315 | $20.16 |
| 86901 | 0% | 2,823 | $0.00 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 246 | $0.00 |
| 83735 | 0% | 900 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 74 | $0.00 |
| 0001A | 0% | 25 | $0.00 | |
| 81001 | 0% | 45 | $0.00 | |
| 96409 | 0% | 19 | $0.00 | |
| 85651 | 0% | 31 | $0.00 | |
| 85730 | 0% | 24 | $0.00 | |
| 82043 | 0% | 13 | $0.00 | |
| 84466 | 0% | 1,932 | $0.00 | |
| 85045 | 0% | 9,382 | $0.00 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | 0% | 89 | $0.00 |
| 84100 | 0% | 845 | $0.00 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | 0% | 109 | $0.00 |
| 86922 | 0% | 42 | $0.00 | |
| J9370 | Vincristine sulfate, 1 mg | 0% | 15 | $0.00 |
| 85384 | 0% | 13 | $0.00 | |
| 82570 | 0% | 14 | $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.