Clinic
Divine Legacy
Divine Legacy was paid $16K by Medicaid between Sep 2022 and Mar 2023, across 1 billing code. Its largest line is H2017, psychosocial rehabilitation, billed per 15 minutes — 100% of everything it billed.
33Billing provider infoDIVINE LEGACY
BROOKLYN CENTER, MN 55429
BROOKLYN CENTER, MN 55429
33aNPI1073072260assigned 03/18/2019
33bProvider typeCorporate Health Clinic/Center
28Total paid$16K
24GClaims227
24DCodes billed1
24AFirst – last monthSep 2022 – Mar 2023
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 | |
|---|---|---|---|
| 2022 | 135 | $9K | |
| 2023 | 92 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H2017 | Psychosocial rehabilitation, billed per 15 minutesPsychosocial rehabilitation services, per 15 minutes | 100% | 227 | 68 | $16K |
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 officialAYCOCK, LAKESIA (ADMINISTRATION/MHP)