Clinic
Grace Southern Medical Clinic, PLLC
Grace Southern Medical Clinic, PLLC was paid $235K by Medicaid between Jan 2018 and Nov 2024, across 17 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 65% of everything it billed.
33Billing provider infoGRACE SOUTHERN MEDICAL CLINIC, PLLC
DALLAS, TX 75228
DALLAS, TX 75228
33aNPI1821486358assigned 01/07/2015
33bProvider typePrimary Care Clinic/Center
28Total paid$235K
24GClaims10,124
24DCodes billed17
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Texas
Rank by total paid#45 of 180
Median peer was paid$25K
This provider vs. median9.3×
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 | 303 | $4K | |
| 2019 | 163 | $3K | |
| 2020 | 1,725 | $26K | |
| 2021 | 2,353 | $58K | |
| 2022 | 2,325 | $57K | |
| 2023 | 1,891 | $53K | |
| 2024incomplete | 1,364 | $35K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 65% | 4,901 | 4,456 | $154K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 27% | 2,086 | 1,952 | $64K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.1% | 772 | 753 | $7K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.1% | 286 | 252 | $3K |
| 90688 | 1.0% | 352 | 342 | $2K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 47 | 44 | $2K |
| 90686 | <1% | 358 | 346 | $1K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 18 | 15 | $992.81 |
| 90656 | <1% | 34 | 34 | $593.98 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | 13 | $180.57 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 299 | 267 | $64.74 |
| 96127 | <1% | 47 | 46 | $5.66 |
5 more codes
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 officialCALIXTO-MONTANEZ, SERGIO (MEMBER)