GRAND LAKE MENTAL HEALTH CENTER, INC.
NPI: 1255704250
· WAGONER, OK 74467
· Mental Health Clinic/Center (Including Community Mental Health Center)
· NPI assigned 11/12/2015
$130K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: DANLEY, CHARLES
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
655 |
$130K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9010 |
Coordinated care fee, risk adjusted maintenance, level 4 |
93 |
84 |
$94K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
535 |
237 |
$30K |
| G9009 |
Coordinated care fee, risk adjusted maintenance, level 3 |
12 |
12 |
$4K |
| G9002 |
Coordinated care fee, maintenance rate |
15 |
13 |
$2K |