GRAND LAKE MENTAL HEALTH CENTER, INC.
NPI: 1407228752
· TAHLEQUAH, OK 74464
· Mental Health Clinic/Center (Including Community Mental Health Center)
· NPI assigned 10/27/2015
$340K
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 |
1,565 |
$236K |
| 2019 |
1,218 |
$104K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9010 |
Coordinated care fee, risk adjusted maintenance, level 4 |
159 |
134 |
$161K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
2,517 |
1,129 |
$158K |
| G9009 |
Coordinated care fee, risk adjusted maintenance, level 3 |
48 |
41 |
$17K |
| G9002 |
Coordinated care fee, maintenance rate |
25 |
25 |
$4K |
| H2015 |
Comprehensive community support services, per 15 minutes |
22 |
14 |
$379.25 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
12 |
12 |
$303.84 |