Physician
Prisma Health Medical Group-Midlands
Prisma Health Medical Group-Midlands was paid $3.66M by Medicaid between Dec 2018 and Dec 2024, across 55 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 59% of everything it billed.
33Billing provider infoPRISMA HEALTH MEDICAL GROUP-MIDLANDS
SUMTER, SC 29150
SUMTER, SC 29150
33aNPI1871080283assigned 04/20/2018
33bProvider typeHospitalist Physician
28Total paid$3.66M
24GClaims117,617
24DCodes billed55
24AFirst – last monthDec 2018 – Dec 2024
Compared with peers
Next to other Hospitalist Physician providers in South Carolina
Rank by total paid#1 of 21
Median peer was paid$87K
This provider vs. median42×
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 LAWRENCE, KRISTI 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 | 1,075 | $33K | |
| 2019 | 19,476 | $623K | |
| 2020 | 19,043 | $614K | |
| 2021 | 18,705 | $612K | |
| 2022 | 19,517 | $621K | |
| 2023 | 23,027 | $654K | |
| 2024incomplete | 16,774 | $506K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 59% | 34,677 | 30,929 | $2.16M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 8.3% | 8,186 | 3,095 | $304K |
| 99223 | Prolong inpt eval add15 m | 3.8% | 1,312 | 1,230 | $140K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.8% | 1,693 | 1,639 | $104K |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.7% | 1,660 | 1,568 | $101K |
| 99460 | 2.5% | 1,124 | 1,066 | $92K | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 2.5% | 1,517 | 1,394 | $90K |
| 59025 | Fetal non-stress test | 2.1% | 2,401 | 1,785 | $76K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.8% | 2,278 | 2,158 | $68K |
| 20610 | 1.4% | 2,983 | 2,527 | $51K | |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 1.3% | 2,804 | 1,709 | $46K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.1% | 377 | 372 | $40K |
43 more codes
| 85018 | <1% | 14,481 | $36K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 11,857 | $34K |
| 81003 | <1% | 13,293 | $31K | |
| 81025 | <1% | 3,784 | $28K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 403 | $22K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 436 | $21K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 283 | $20K |
| 76830 | Ultrasound, transvaginal | <1% | 194 | $19K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 142 | $16K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 190 | $15K |
| 99462 | <1% | 404 | $15K | |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | <1% | 154 | $14K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 313 | $14K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 13 | $13K |
| 62323 | <1% | 319 | $10K | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 2,646 | $10K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 129 | $9K |
| 59514 | <1% | 12 | $9K | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 2,879 | $8K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 741 | $8K |
| 90686 | <1% | 470 | $7K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,484 | $6K |
| 59430 | <1% | 37 | $6K | |
| 99078 | <1% | 125 | $4K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 41 | $4K |
| 99221 | <1% | 54 | $3K | |
| 90715 | <1% | 66 | $3K | |
| 99219 | <1% | 30 | $2K | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 345 | $2K |
| 93922 | <1% | 442 | $2K | |
| 76801 | <1% | 12 | $1K | |
| 93925 | <1% | 139 | $1K | |
| 93970 | <1% | 43 | $780.88 | |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 347 | $780.28 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 22 | $336.00 |
| 99441 | <1% | 25 | $298.86 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 24 | $214.03 |
| 11045 | <1% | 14 | $149.66 | |
| 93926 | <1% | 17 | $129.96 | |
| 93880 | <1% | 13 | $125.19 | |
| 3074F | <1% | 120 | $0.53 | |
| 3078F | <1% | 49 | $0.23 | |
| 36416 | 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 officialLAWRENCE, KRISTI (DIRECTOR PROVIDER ENROLLMENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.