JACKSON HOSPITAL AND CLINIC INC
NPI: 1164803367
· MONTGOMERY, AL 36117
· Urology Physician
· NPI assigned 06/12/2015
$658.70
Total Medicaid Paid
Provider Details
| Authorized Official | PENNEY, KELIN (ADMINISTRATOR) |
| Parent Organization | JACKSON HOSPITAL AND CLINIC INC |
| NPI Enumeration Date | 06/12/2015 |
Related Entities
Other providers sharing the same authorized official: PENNEY, KELIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
14 |
$0.00 |
| 2023 |
13 |
$658.70 |
| 2024 |
13 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$658.70 |
| 1036F |
|
27 |
25 |
$0.00 |