GRACE DIVINE, LLC

$407K

Total Medicaid Paid

33,261

Total Claims

25,836

Beneficiaries

43

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99349		11,923	9,271	$213K
99350	Prolong home eval add 15m	4,732	3,711	$146K
99336		2,546	1,896	$33K
99337		578	472	$11K
99328		28	24	$977.06
99348		64	54	$502.48
90688		203	131	$474.26
99354		66	50	$344.34
90674		139	134	$329.25
99454		284	212	$264.89
G0438	Ppps, initial visit	488	377	$260.76
99344		12	12	$241.16
99457		290	212	$201.94
99491	Ccm add 20min	333	282	$67.70
99453		35	30	$3.63
G8752	Sys bp less 140	2,560	1,928	$0.00
G0179	Md recertification hha pt	955	924	$0.00
99490	Ccm add 20min	703	621	$0.00
99497		1,202	943	$0.00
G0444	Depression screen annual	97	40	$0.00
99499		16	12	$0.00
3077F		38	27	$0.00
G0181	Home health care supervision	179	167	$0.00
1159F		56	48	$0.00
1160F		42	36	$0.00
3078F		44	38	$0.00
G8417	Calc bmi abv up param f/u	16	12	$0.00
99358	Prolong nursin fac eval 15m	13	13	$0.00
G8754	Dias bp less 90	3,323	2,474	$0.00
G0008	Admin influenza virus vac	236	197	$0.00
G0439	Ppps, subseq visit	280	249	$0.00
1111F		281	212	$0.00
G8755	Dias bp > or = 90	23	12	$0.00
G0506	Comp asses care plan ccm svc	130	102	$0.00
1170F		358	210	$0.00
G8420	Calc bmi norm parameters	40	25	$0.00
1126F		254	190	$0.00
1125F		123	70	$0.00
G0180	Md certification hha patient	212	205	$0.00
3079F		168	90	$0.00
99335		15	14	$0.00
99406		163	97	$0.00
1036F		13	12	$0.00

Medicaid Provider Spending