Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $148K by Medicaid between Sep 2023 and Nov 2024, across 13 billing codes. Its largest line is 94760, — 37% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREENVILLE, SC 29607
GREENVILLE, SC 29607
33aNPI1922788728assigned 07/18/2023
33bProvider typeGeneral Acute Care Hospital
28Total paid$148K
24GClaims3,415
24DCodes billed13
24AFirst – last monthSep 2023 – Nov 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#83 of 115
Median peer was paid$2.47M
This provider vs. median0.1×
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 | |
|---|---|---|---|
| 2023 | 1,185 | $35K | |
| 2024incomplete | 2,230 | $113K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 94760 | 37% | 973 | 917 | $55K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 1,048 | 986 | $38K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 7.7% | 185 | 185 | $11K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7.5% | 194 | 193 | $11K |
| 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 | 5.8% | 548 | 523 | $9K |
| 87428 | 5.8% | 83 | 82 | $9K | |
| 87081 | 4.9% | 96 | 96 | $7K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 3.0% | 181 | 180 | $4K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1.8% | 22 | 22 | $3K |
| 87807 | <1% | 35 | 35 | $972.12 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 22 | 22 | $0.00 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 15 | 14 | $0.00 |
1 more codes
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 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 (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.