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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Prisma Health-Upstate
⚕️
Organization

Prisma Health-Upstate

NPI: 1740735513
Greenville, SC
8 years of data
Ambulance Service Provider
$20.8M
Total Payments
55
Beneficiaries
907.1K
Services
2.06x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$20.8M
Specialty median$479.2K

📋 Key Findings

1Billed $20.8M over 8 years
22.06x markup ratio (above median)
399th percentile in Ambulance Service Provider by payments
4Payments surged 317% in 2017
✓ No flags detected

🔎 Data Analysis

This provider's $20.8M in total Medicare payments ranks in the 99th percentile of Ambulance Service Provider providers nationally.

Medicare payments to this provider grew 1138% from 2016 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 317% in 2017

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2016$32.10$17.801.80x$14.30$365.6K20.5K6
2017$30.50$17.001.79x$13.50$1.5M89.6K7
2018$32.83$18.421.78x$14.41$1.9M105.1K7
2019$45.03$18.802.40x$26.23$2.1M110.8K7
2020$48.02$21.242.26x$26.78$2.6M120.4K7
2021$52.29$24.222.16x$28.07$3.7M153.5K7
2022$55.87$26.932.07x$28.94$4.1M150.7K7
2023$55.43$28.931.92x$26.50$4.5M156.5K7

Top Procedures (7)

A0428Ambulance service, basic life support, non-emergency transport, (bls)
$6.3M
35.3K services$177.88/svc2.18x markup
A0425Ground mileage, per statute mile
$5.7M
844.4K services$6.72/svc2.28x markup
A0427Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)
$4.8M
14.1K services$344.30/svc1.88x markup
A0429Ambulance service, basic life support, emergency transport (bls-emergency)
$2.3M
7.6K services$295.58/svc1.67x markup
A0426Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)
$864.7K
4.1K services$211.16/svc1.89x markup
A0434Specialty care transport (sct)
$460.3K
794 services$579.77/svc1.98x markup
A0433Advanced life support, level 2 (als 2)
$381.5K
765 services$498.76/svc1.86x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
A0428Ambulance service, basic life support, non-emergency transport, (bls)35.3K$6.3M$177.882.18x
A0425Ground mileage, per statute mile844.4K$5.7M$6.722.28x
A0427Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)14.1K$4.8M$344.301.88x
A0429Ambulance service, basic life support, emergency transport (bls-emergency)7.6K$2.3M$295.581.67x
A0426Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)4.1K$864.7K$211.161.89x
A0434Specialty care transport (sct)794$460.3K$579.771.98x
A0433Advanced life support, level 2 (als 2)765$381.5K$498.761.86x

Markup Analysis

Charge-to-Payment Ratio

2.06x

This provider submits charges 2.06 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.06x means for every $100 Medicare pays, this provider initially charges $206. This is higher than the national average.

Location

Greenville, SC

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Ambulance Service Provider providers in SC for peer comparison.

Prisma Health-Upstate (you)
$20.8M
Medshore Ambulance Service, Llc⚠️
$65.2M
Vital Care Ems
$48.3M
County Of Greenville
$44.4M
Personal Care, Inc.
$40.5M
Charleston County Government
$40.2M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Medshore Ambulance Service, LlcAnderson, SC$65.2M⚠️ Flagged
Vital Care EmsPiedmont, SC$48.3M✓ Clear
County Of GreenvilleGreenville, SC$44.4M✓ Clear
Personal Care, Inc.Charleston, SC$40.5M✓ Clear
Charleston County GovernmentNorth Charleston, SC$40.2M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

Believe this data is inaccurate? Dispute this data