GRACE PRIMARY CARE, PC

$1.22M

Total Medicaid Paid

103,975

Total Claims

77,552

Beneficiaries

63

Codes Billed

2018-01

First Month

2024-01

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99213		16,625	13,865	$552K
99214		9,896	8,462	$338K
87804		12,461	5,055	$123K
87880		6,047	5,144	$60K
96372		3,543	2,247	$33K
85025		5,589	4,857	$29K
96110		1,120	946	$26K
87811		560	504	$19K
G2023	Specimen collect covid-19	1,560	930	$15K
87807		755	637	$7K
81003		1,685	1,482	$2K
J1040	Methylprednisolone 80 mg inj	294	267	$2K
3008F		18,790	14,164	$2K
99173		307	278	$2K
92551		239	215	$2K
J0696	Ceftriaxone sodium injection	866	720	$1K
99392		16	14	$845.68
96127		221	186	$815.69
99394		18	12	$791.02
J3301	Triamcinolone acet inj nos	300	260	$679.54
95117		94	49	$554.53
99211		29	14	$543.69
99391		23	13	$488.89
99212		18	16	$373.98
90686		98	89	$317.07
90756		39	39	$166.73
G0444	Depression screen annual	56	37	$106.34
90471		33	30	$100.47
G0439	Ppps, subseq visit	70	49	$83.52
3078F		245	157	$70.00
94760		184	133	$51.87
3074F		223	138	$50.00
83735		48	47	$31.16
3075F		55	38	$30.00
80053		50	49	$27.18
1170F		94	70	$20.00
1125F		71	57	$20.00
82550		27	27	$17.64
80061		25	25	$12.04
G0008	Admin influenza virus vac	69	65	$3.13
0528F		56	37	$0.00
96160		54	36	$0.00
1090F		55	37	$0.00
3755F		57	38	$0.00
1160F		151	112	$0.00
1159F		151	112	$0.00
0521F		57	39	$0.00
0556F		56	37	$0.00
1124F		23	12	$0.00
3288F		55	37	$0.00
0518F		55	37	$0.00
2010F		18,230	13,816	$0.00
0513F		1,863	1,353	$0.00
3011F		122	75	$0.00
1110F		93	68	$0.00
1220F		58	39	$0.00
M1069	Pt scr ft fall rsk	55	37	$0.00
1022F		57	38	$0.00
1111F		143	106	$0.00
1030F		56	37	$0.00
1000F		55	37	$0.00
3079F		15	12	$0.00
G9664	Taking statin or rec'd order	15	13	$0.00

Medicaid Provider Spending