Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

GRACE FAMILY PRACTICE CLINIC, P.C.

NPI: 1083124671 · DYERSBURG, TN 38024 · Family Medicine Physician · NPI assigned 10/09/2017

$1.25M
Total Medicaid Paid
44,662
Total Claims
39,622
Beneficiaries
42
Codes Billed
2018-12
First Month
2024-12
Last Month

Provider Details

Authorized OfficialCASEY-BOLDEN, MONIQUE (PRESIDENT)
NPI Enumeration Date10/09/2017

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 158 $4K
2019 1,532 $49K
2020 1,584 $50K
2021 12,024 $332K
2022 11,331 $320K
2023 11,320 $301K
2024 6,713 $194K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 14,955 12,847 $612K
90460 Immunization administration through 18 years of age via any route, first or only component 2,920 2,731 $160K
96110 Developmental screening, with scoring and documentation, per standardized instrument 4,917 4,449 $104K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,668 1,457 $102K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,415 1,332 $97K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 7,096 6,608 $69K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 407 390 $27K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 1,522 702 $18K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 132 125 $10K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 269 249 $8K
90677 92 82 $8K
99238 Hospital discharge day management, 30 minutes or less 92 90 $5K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 309 284 $4K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 72 62 $4K
99460 81 78 $4K
92551 399 380 $3K
99173 550 518 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 35 28 $2K
99381 27 25 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 156 148 $1K
90651 67 57 $1K
90670 1,064 1,013 $1K
36415 Collection of venous blood by venipuncture 550 500 $813.60
85025 Blood count; complete (CBC), automated, and automated differential WBC count 136 120 $749.01
J0696 Injection, ceftriaxone sodium, per 250 mg 408 370 $730.23
90686 82 81 $651.16
90688 66 63 $441.55
90680 697 670 $323.35
90723 794 763 $298.92
90707 392 364 $203.70
90656 21 16 $181.93
90716 381 349 $166.79
81002 69 64 $126.72
90734 17 12 $111.73
90633 514 473 $99.21
90700 439 401 $84.59
90461 580 523 $58.56
90648 873 823 $54.04
90713 131 122 $43.10
90661 40 39 $23.46
96160 20 15 $0.00
99000 207 199 $0.00