STATE OF MISSISSIPPI- UNIVERSITY OF MISSISSIPPI MEDICAL CENTER

NPI: 1689810327 · JACKSON, MS 39216 · Children's Hospital · NPI assigned 12/31/2008

$203.52

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2021-07

First Month

2021-07

Last Month

Provider Details

Authorized Official	BROWN, MICHELLE (DIRECTOR OF PATIENT FINANCIAL SERV)
NPI Enumeration Date	12/31/2008

Other providers sharing the same authorized official: BROWN, MICHELLE

Provider	City	State	Total Paid
FRIENDS & FAMILY ADULT DAY SERVICES, INC.	WINDSOR MILL	MD	$4.50M
MICHELLE D. BROWN DDS, & MICHAEL B. MOORE DDS, INC.	OCEANA	WV	$2.42M
PROVIDENTIAL BBA OPERATING LP	BOUNTIFUL	UT	$1.73M
SUNDANCE DENTAL CARE OF RIO RANCHO, LLC	RIO RANCHO	NM	$971K

Year	Claims	Total Paid
2021	42	$203.52

Code	Description	Claims	Beneficiaries	Total Paid
99283	Emergency department visit for the evaluation and management, moderate severity	15	14	$181.02
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	12	12	$22.50
99284	Emergency department visit for the evaluation and management, high severity	15	15	$0.00