Hospital
Prisma Health-Upstate
Prisma Health-Upstate was paid $10.91M by Medicaid between Jan 2018 and Dec 2024, across 205 billing codes. Its largest line is 80053, Comprehensive metabolic panel — 12% of everything it billed.
33Billing provider infoPRISMA HEALTH-UPSTATE
GREER, SC 29650
GREER, SC 29650
33aNPI1982150009assigned 08/29/2016
33bProvider typeGeneral Acute Care Hospital
28Total paid$10.91M
24GClaims492,575
24DCodes billed205
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in South Carolina
Rank by total paid#30 of 115
Median peer was paid$2.47M
This provider vs. median4.4×
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 | 67,125 | $1.44M | |
| 2019 | 71,649 | $1.45M | |
| 2020 | 68,688 | $1.51M | |
| 2021 | 79,706 | $1.71M | |
| 2022 | 76,560 | $1.85M | |
| 2023 | 70,412 | $1.69M | |
| 2024incomplete | 58,435 | $1.24M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 80053 | Comprehensive metabolic panel | 12% | 21,220 | 18,490 | $1.29M |
| 36415 | Collection of venous blood by venipuncture | 11% | 19,488 | 16,540 | $1.19M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 8.2% | 25,536 | 24,274 | $897K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 6.3% | 6,731 | 6,578 | $683K |
| 80048 | Basic metabolic panel (calcium, ionized) | 5.5% | 11,212 | 9,652 | $595K |
| 81025 | 3.9% | 10,574 | 9,959 | $429K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 3.7% | 5,488 | 5,299 | $401K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 3.0% | 3,662 | 3,496 | $330K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 3.0% | 4,613 | 3,587 | $325K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.9% | 7,895 | 5,098 | $315K |
| 87081 | 2.9% | 3,165 | 3,097 | $312K | |
| 96361 | Intravenous infusion, hydration; each additional hour | 2.8% | 9,990 | 8,161 | $309K |
193 more codes
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | 2.2% | 9,953 | $241K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.8% | 1,553 | $195K |
| 81001 | 1.7% | 14,572 | $188K | |
| 99284 | Emergency room visit (serious) | 1.7% | 15,072 | $181K |
| 76830 | Ultrasound, transvaginal | 1.4% | 1,734 | $149K |
| 86850 | 1.3% | 1,845 | $139K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.2% | 2,782 | $132K |
| 86900 | 1.2% | 2,474 | $129K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 3,075 | $109K |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 585 | $108K |
| 82565 | <1% | 496 | $107K | |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 4,477 | $101K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 6,231 | $97K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 3,580 | $88K |
| 73610 | <1% | 1,563 | $87K | |
| 73630 | <1% | 1,747 | $83K | |
| 99285 | Emergency room visit (most serious) | <1% | 16,271 | $82K |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 5,691 | $81K |
| 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | <1% | 95 | $77K |
| 81003 | <1% | 4,228 | $70K | |
| 73130 | <1% | 869 | $69K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 2,337 | $67K |
| 74018 | <1% | 1,537 | $59K | |
| 87077 | <1% | 2,417 | $57K | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 1,908 | $55K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 1,417 | $51K |
| 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% | 801 | $50K |
| 84702 | <1% | 2,584 | $50K | |
| 73110 | <1% | 673 | $46K | |
| 71045 | Radiologic examination, chest; single view | <1% | 7,171 | $46K |
| 73564 | <1% | 1,504 | $43K | |
| 87210 | <1% | 1,398 | $41K | |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 700 | $39K |
| 93971 | <1% | 216 | $35K | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 2,575 | $35K |
| 73030 | <1% | 759 | $33K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,078 | $32K |
| 71250 | <1% | 137 | $31K | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 1,849 | $31K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 12,502 | $30K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 32,502 | $30K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 2,068 | $24K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 735 | $24K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 568 | $23K |
| 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% | 1,403 | $21K |
| J7120 | Ringers lactate infusion, up to 1000 cc | <1% | 7,636 | $20K |
| 71275 | Computed tomographic angiography, chest, with contrast material | <1% | 1,040 | $19K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 1,702 | $19K |
| G0378 | Hospital observation service, per hour | <1% | 2,901 | $18K |
| 72110 | <1% | 568 | $17K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 7,552 | $16K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 179 | $16K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,299 | $14K |
| 96376 | <1% | 2,930 | $13K | |
| 76770 | <1% | 197 | $12K | |
| 84484 | <1% | 7,126 | $10K | |
| 70496 | <1% | 75 | $10K | |
| 93017 | <1% | 222 | $10K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 2,536 | $9K |
| 73140 | <1% | 69 | $7K | |
| 80076 | <1% | 1,986 | $7K | |
| 0202U | Oncology (prostate), multianalyte, gene expression profiling | <1% | 90 | $7K |
| 12001 | <1% | 88 | $7K | |
| 72125 | Computed tomography, cervical spine; without contrast material | <1% | 763 | $7K |
| 85027 | <1% | 3,034 | $7K | |
| 76775 | <1% | 193 | $6K | |
| 86140 | <1% | 2,735 | $6K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 194 | $6K |
| 73080 | <1% | 89 | $5K | |
| 70551 | Magnetic resonance imaging, brain; without contrast material | <1% | 12 | $5K |
| J3490 | Unclassified drugs | <1% | 5,593 | $4K |
| 73090 | <1% | 53 | $4K | |
| 87070 | <1% | 13 | $4K | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 166 | $4K |
| 87807 | <1% | 288 | $4K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 29 | $4K |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 9,101 | $4K |
| J2550 | Injection, promethazine hcl, up to 50 mg | <1% | 1,569 | $3K |
| 82247 | <1% | 670 | $3K | |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | <1% | 13 | $3K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 2,971 | $3K |
| J1650 | Injection, enoxaparin sodium, 10 mg | <1% | 1,618 | $3K |
| 76536 | <1% | 39 | $3K | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 7,467 | $3K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 1,282 | $3K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 8,619 | $2K |
| 73590 | <1% | 30 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 117 | $2K |
| J1644 | Injection, heparin sodium, per 1000 units | <1% | 1,031 | $2K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 212 | $2K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 3,583 | $2K |
| 85379 | <1% | 2,014 | $2K | |
| 93976 | <1% | 1,191 | $2K | |
| 84145 | <1% | 911 | $1K | |
| 86308 | <1% | 29 | $1K | |
| 12011 | <1% | 14 | $1K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 234 | $1K |
| J2270 | Injection, morphine sulfate, up to 10 mg | <1% | 2,744 | $1K |
| J2003 | Injection, lidocaine hydrochloride, 1 mg | <1% | 75 | $1K |
| 97597 | <1% | 19 | $1K | |
| 80061 | Lipid panel | <1% | 3,037 | $993.96 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 3,597 | $829.79 |
| 85007 | <1% | 1,404 | $789.09 | |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | <1% | 21 | $782.71 |
| 87400 | <1% | 21 | $771.37 | |
| 83690 | <1% | 7,702 | $745.03 | |
| 72040 | <1% | 28 | $744.69 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 4,198 | $714.70 |
| 82803 | <1% | 649 | $696.74 | |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 618 | $690.31 |
| J1596 | Injection, glycopyrrolate, 0.1 mg | <1% | 161 | $681.08 |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | <1% | 937 | $678.75 |
| 74022 | <1% | 65 | $629.33 | |
| 83735 | <1% | 4,973 | $505.29 | |
| 83605 | <1% | 2,822 | $446.75 | |
| 82077 | <1% | 826 | $422.30 | |
| 87040 | <1% | 1,505 | $413.02 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 2,601 | $398.79 |
| 93308 | <1% | 94 | $392.28 | |
| 84439 | <1% | 578 | $386.39 | |
| 80143 | <1% | 117 | $378.44 | |
| 85610 | <1% | 3,095 | $365.80 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 6,626 | $363.13 |
| 82728 | <1% | 557 | $358.60 | |
| J0330 | Injection, succinylcholine chloride, up to 20 mg | <1% | 774 | $356.51 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | <1% | 3,959 | $337.56 |
| 83880 | <1% | 2,325 | $271.58 | |
| 83655 | <1% | 614 | $209.42 | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 45 | $197.05 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,141 | $167.08 |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 2,024 | $158.70 |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 58 | $121.87 |
| 85730 | <1% | 1,623 | $42.50 | |
| J0690 | Injection, cefazolin sodium, 500 mg | <1% | 1,917 | $40.72 |
| 86901 | <1% | 2,474 | $39.58 | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 441 | $31.58 |
| 87186 | <1% | 1,800 | $26.67 | |
| J3475 | Injection, magnesium sulfate, per 500 mg | <1% | 852 | $21.63 |
| J1170 | Injection, hydromorphone, up to 4 mg | <1% | 3,449 | $14.87 |
| 84466 | <1% | 309 | $11.64 | |
| J1200 | Injection, diphenhydramine hcl, up to 50 mg | <1% | 1,856 | $8.12 |
| 84100 | <1% | 1,530 | $6.33 | |
| 83540 | <1% | 416 | $5.90 | |
| A9585 | Injection, gadobutrol, 0.1 ml | <1% | 376 | $1.95 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 2,108 | $1.76 |
| J0665 | Injection, bupivicaine, not otherwise specified, 0.5 mg | 0% | 72 | $0.00 |
| J2710 | Injection, neostigmine methylsulfate, up to 0.5 mg | 0% | 649 | $0.00 |
| J2272 | Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg | 0% | 877 | $0.00 |
| 82248 | 0% | 51 | $0.00 | |
| J0780 | Injection, prochlorperazine, up to 10 mg | 0% | 134 | $0.00 |
| J3370 | Injection, vancomycin hcl, 500 mg | 0% | 20 | $0.00 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | 0% | 12 | $0.00 |
| 80179 | 0% | 65 | $0.00 | |
| 90715 | 0% | 166 | $0.00 | |
| 84460 | 0% | 26 | $0.00 | |
| 59025 | Fetal non-stress test | 0% | 15 | $0.00 |
| 85014 | 0% | 31 | $0.00 | |
| 96367 | 0% | 67 | $0.00 | |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 0% | 45 | $0.00 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 0% | 117 | $0.00 |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 0% | 14 | $0.00 |
| 88312 | 0% | 12 | $0.00 | |
| 84450 | 0% | 25 | $0.00 | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | 0% | 96 | $0.00 |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 0% | 28 | $0.00 |
| J1171 | Injection, hydromorphone, 0.1 mg | 0% | 69 | $0.00 |
| J2919 | Injection, methylprednisolone sodium succinate, 5 mg | 0% | 15 | $0.00 |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 0% | 16 | $0.00 |
| J0688 | Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg | 0% | 18 | $0.00 |
| 82550 | 0% | 240 | $0.00 | |
| 85651 | 0% | 788 | $0.00 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 0% | 836 | $0.00 |
| 97162 | 0% | 180 | $0.00 | |
| J1815 | Injection, insulin, per 5 units | 0% | 898 | $0.00 |
| 88304 | 0% | 79 | $0.00 | |
| 85652 | 0% | 864 | $0.00 | |
| 87486 | 0% | 29 | $0.00 | |
| 70498 | 0% | 79 | $0.00 | |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 0% | 816 | $0.00 |
| J2060 | Injection, lorazepam, 2 mg | 0% | 133 | $0.00 |
| 82607 | 0% | 115 | $0.00 | |
| 85018 | 0% | 62 | $0.00 | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 0% | 14 | $0.00 |
| J2371 | Injection, phenylephrine hydrochloride, 20 micrograms | 0% | 13 | $0.00 |
| J1790 | Injection, droperidol, up to 5 mg | 0% | 12 | $0.00 |
| J0131 | Injection, acetaminophen, not otherwise specified,10 mg | 0% | 90 | $0.00 |
| J2785 | Injection, regadenoson, 0.1 mg | 0% | 29 | $0.00 |
| J1940 | Injection, furosemide, up to 20 mg | 0% | 23 | $0.00 |
| 87581 | 0% | 29 | $0.00 | |
| J2543 | Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) | 0% | 27 | $0.00 |
| J8540 | Dexamethasone, oral, 0.25 mg | 0% | 12 | $0.00 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 14 | $0.00 |
| 87205 | 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.