NPI: 1316340094 · GRAND RAPIDS, MI 49503 · Clinical Social Worker · NPI assigned 10/08/2014
Authorized official BLACKMON, TASHA controls 20+ related entities in our dataset. Read more
| Authorized Official | BLACKMON, TASHA (CEO) |
| Parent Organization | CHERRY STREET SERVICES, INC. |
| NPI Enumeration Date | 10/08/2014 |
Other providers sharing the same authorized official: BLACKMON, TASHA
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,208 | $92K |
| 2019 | 1,861 | $62K |
| 2020 | 570 | $15K |
| 2021 | 25 | $696.34 |
| 2022 | 262 | $8K |
| 2023 | 856 | $27K |
| 2024 | 560 | $22K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 1,621 | 1,341 | $106K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | 662 | 349 | $50K |
| D1110 | Prophylaxis - adult | 687 | 686 | $34K |
| D1206 | Topical application of fluoride varnish | 669 | 668 | $9K |
| D0120 | Periodic oral evaluation - established patient | 314 | 314 | $9K |
| D0274 | Bitewings - four radiographic images | 156 | 156 | $5K |
| D0210 | Intraoral - complete series of radiographic images | 69 | 69 | $5K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 957 | 844 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 20 | 12 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 123 | 122 | $884.29 |
| D1351 | Sealant - per tooth | 45 | 13 | $841.00 |
| G0466 | Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 15 | 15 | $828.35 |
| 96127 | 1,011 | 865 | $698.18 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 159 | 155 | $308.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 201 | 181 | $122.80 |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 16 | 14 | $121.24 |
| 90832 | Psychotherapy, 30 minutes with patient | 14 | 12 | $93.48 |
| 86703 | 17 | 15 | $80.92 | |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 105 | 69 | $67.11 |
| 90472 | Immunization administration, each additional vaccine (list separately) | 34 | 34 | $63.00 |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 14 | 14 | $60.66 |
| 85018 | 50 | 50 | $34.10 | |
| 99173 | 176 | 176 | $0.00 | |
| 90837 | Psychotherapy, 53 minutes with patient | 39 | 24 | $0.00 |
| 90686 | 62 | 61 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 33 | 33 | $0.00 |
| 90620 | 33 | 33 | $0.00 | |
| 90834 | Psychotherapy, 45 minutes with patient | 40 | 26 | $0.00 |