State of Mississippi - University of Mississippi Medical Center
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 93 procedure codes: 99284 at 2.5× median, 99285 at 2.7× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $646.75 per claim for G0378 (Hospital observation service, per hour) — 6.5× the national median of $99.39.
Bills $2,218.64 per claim for 42820 (Tonsillectomy and adenoidectomy, under age 12) — 6.7× the national median of $331.68.
Bills $779.37 per claim for 69436 (Tympanostomy, general anesthesia) — 3.8× the national median of $205.50.
Billing in the top 1% nationally for 1 procedure code: 94375.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $506.7M is at the 90th percentile among 156 General Acute Care Hospital providers.
Above 90th percentile for this specialty — higher spending than 140 of 156 peers
Total Paid
$506.7M
$506,717,191
Total Claims
10.0M
Beneficiaries
7.5M
1.3 claims/patient
Avg Cost/Claim
$50
#119 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
State of Mississippi - University of Mississippi Medical Center is a General Acute Care Hospital provider based in Jackson, MS. From the 2018–2024 period, this provider received $506.7M in Medicaid payments across 10.0M claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $506.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 63,339 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 7% of total spending.
$36.2M
206K claims
$175.52
$69.51
Emergency dept visit, high complexity
$36.2M
206K claims · 7.1%
$27.4M
42K claims
$646.75
$99.39
Hospital observation service, per hour
$27.4M
42K claims · 5.4%
$24.5M
240K claims
$101.96
$42.48
Emergency dept visit, moderate complexity
$24.5M
240K claims · 4.8%
$24.3M
105K claims
$231.21
$85.65
Emergency dept visit, high/urgent complexity
$24.3M
105K claims · 4.8%
$19.5M
356K claims
$54.72
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$19.5M
356K claims · 3.8%
$14.2M
6K claims
$2,218.64
$331.68
Tonsillectomy and adenoidectomy, under age 12
$14.2M
6K claims · 2.8%
$12.9M
323K claims
$39.98
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$12.9M
323K claims · 2.5%
$12.3M
2K claims
$6,162.43
$5,391.55
Injection, pembrolizumab, 1 mg
$12.3M
2K claims · 2.4%
Tympanostomy, general anesthesia
$8.6M
11K claims · 1.7%
$7.6M
53K claims
$143.48
$54.68
Echocardiography, transthoracic, complete, with Doppler
$7.6M
53K claims · 1.5%
$6.4M
36K claims
$180.40
$112.83
Echocardiography, transthoracic, limited
$6.4M
36K claims · 1.3%
$6.1M
21K claims · 1.2%
$5.9M
8K claims
$776.60
$470.36
Injection, onabotulinumtoxinA, 1 unit
$5.9M
8K claims · 1.2%
$5.4M
73K claims
$73.56
$74.09
Office/outpatient visit, high complexity
$5.4M
73K claims · 1.1%
$5.3M
20K claims
$256.52
$293.45
Subsequent intensive care, very low birth weight infant
$5.3M
20K claims · 1.0%
$5.2M
116K claims
$44.58
$35.30
Subsequent hospital care, per day, high complexity
$5.2M
116K claims · 1.0%
$4.9M
21K claims
$235.74
$307.98
Subsequent pediatric critical care, per day, age 2-5
$4.9M
21K claims · 1.0%
$4.6M
29K claims
$157.95
$133.68
MRI brain without contrast, then with contrast
$4.6M
29K claims · 0.9%
$4.6M
132K claims
$34.66
$23.99
Subsequent hospital care, per day, moderate complexity
$4.6M
132K claims · 0.9%
$4.4M
26K claims
$167.48
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$4.4M
26K claims · 0.9%
$4.3M
41K claims
$105.86
$21.76
Therapeutic/prophylactic/diagnostic IV push, single substance
$4.3M
41K claims · 0.9%
$3.5M
53K claims
$66.22
$37.72
Emergency dept visit, low complexity
$3.5M
53K claims · 0.7%
$3.4M
47K claims · 0.7%
$3.3M
2K claims
$1,663.19
$1,650.68
Ambulance service, conventional air, transport, one way
$3.3M
2K claims · 0.6%
$3.1M
32K claims
$96.65
$65.76
CT abdomen and pelvis with contrast
$3.1M
32K claims · 0.6%
$3.1M
19K claims
$159.92
$10.88
Pressurized or nonpressurized inhalation treatment
$3.1M
19K claims · 0.6%
$3.0M
22K claims · 0.6%
$2.9M
2K claims
$1,766.54
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$2.9M
2K claims · 0.6%
$2.9M
2K claims · 0.6%
$2.8M
12K claims
$232.90
$260.56
Intensity modulated radiation treatment delivery, complex
$2.8M
12K claims · 0.6%
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