Grace Family Practice Clinic, P.C.

Grace Family Practice Clinic, P.C. was paid $1.25M by Medicaid between Dec 2018 and Dec 2024, across 42 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 49% of everything it billed.

33Billing provider infoGRACE FAMILY PRACTICE CLINIC, P.C.
DYERSBURG, TN 38024

33aNPI1083124671assigned 10/09/2017

33bProvider typeFamily Medicine Physician

28Total paid$1.25M

24GClaims44,662

24DCodes billed42

24AFirst – last monthDec 2018 – Dec 2024

Compared with peers

Next to other Family Medicine Physician providers in Tennessee

Rank by total paid#47 of 754

Median peer was paid$34K

This provider vs. median37×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

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

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	49%	14,955	12,847	$612K
90460	Immunization administration through 18 years of age via any route, first or only component	13%	2,920	2,731	$160K
96110	Developmental screening, with scoring and documentation, per standardized instrument	8.3%	4,917	4,449	$104K
99391	Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year)	8.2%	1,668	1,457	$102K
99392	Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years)	7.8%	1,415	1,332	$97K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	5.5%	7,096	6,608	$69K
99393	Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years)	2.1%	407	390	$27K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	1.4%	1,522	702	$18K
99394	Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years)	<1%	132	125	$10K
87811	Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19)	<1%	269	249	$8K
90677		<1%	92	82	$8K
99238	Hospital discharge day management, 30 minutes or less	<1%	92	90	$5K

30 more codes

96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	309	$4K
99214	Doctor's office visit, returning patient (more involved)	<1%	72	$4K
99460		<1%	81	$4K
92551		<1%	399	$3K
99173		<1%	550	$2K
99203	Doctor's office visit, new patient (routine)	<1%	35	$2K
99381		<1%	27	$2K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	156	$1K
90651		<1%	67	$1K
90670		<1%	1,064	$1K
36415	Collection of venous blood by venipuncture	<1%	550	$813.60
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	136	$749.01
J0696	Injection, ceftriaxone sodium, per 250 mg	<1%	408	$730.23
90686		<1%	82	$651.16
90688		<1%	66	$441.55
90680		<1%	697	$323.35
90723		<1%	794	$298.92
90707		<1%	392	$203.70
90656		<1%	21	$181.93
90716		<1%	381	$166.79
81002		<1%	69	$126.72
90734		<1%	17	$111.73
90633		<1%	514	$99.21
90700		<1%	439	$84.59
90461		<1%	580	$58.56
90648		<1%	873	$54.04
90713		<1%	131	$43.10
90661		<1%	40	$23.46
96160		0%	20	$0.00
99000		0%	207	$0.00

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 officialCASEY-BOLDEN, MONIQUE (PRESIDENT)