NPI: 1770656605 · GRAND RAPIDS, MI 49507 · Dentist · NPI assigned 11/16/2006
Authorized official BLACKMON, TASHA controls 20+ related entities in our dataset. Read more
| Authorized Official | BLACKMON, TASHA (CEO) |
| NPI Enumeration Date | 11/16/2006 |
Other providers sharing the same authorized official: BLACKMON, TASHA
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 7,966 | $210K |
| 2019 | 8,145 | $204K |
| 2020 | 4,810 | $92K |
| 2021 | 7,971 | $168K |
| 2022 | 7,264 | $193K |
| 2023 | 8,911 | $254K |
| 2024 | 4,906 | $149K |
| 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 | 9,405 | 8,486 | $629K |
| 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 | 1,875 | 989 | $120K |
| D1351 | Sealant - per tooth | 3,505 | 862 | $102K |
| D1120 | Prophylaxis - child | 1,900 | 1,899 | $73K |
| D0120 | Periodic oral evaluation - established patient | 1,962 | 1,962 | $58K |
| D1206 | Topical application of fluoride varnish | 1,894 | 1,894 | $45K |
| D1110 | Prophylaxis - adult | 673 | 673 | $38K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4,455 | 4,076 | $26K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1,602 | 1,526 | $20K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 182 | 129 | $18K |
| D0210 | Intraoral - complete series of radiographic images | 288 | 264 | $17K |
| D0272 | Bitewings - two radiographic images | 714 | 714 | $15K |
| 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 | 155 | 155 | $14K |
| D0274 | Bitewings - four radiographic images | 387 | 387 | $13K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 831 | 808 | $11K |
| D2140 | 115 | 83 | $9K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 168 | 168 | $9K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3,814 | 3,690 | $6K |
| 90651 | 445 | 438 | $5K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1,531 | 1,491 | $5K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | 44 | 39 | $4K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 32 | 25 | $4K |
| D0220 | Intraoral - periapical first radiographic image | 232 | 222 | $4K |
| 0054A | 117 | 117 | $3K | |
| 0001A | 90 | 89 | $3K | |
| 90837 | Psychotherapy, 53 minutes with patient | 415 | 251 | $3K |
| 0002A | 62 | 61 | $2K | |
| 96127 | 4,180 | 3,832 | $2K | |
| D0240 | 85 | 44 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 111 | 111 | $1K |
| 0072A | 33 | 33 | $1K | |
| 90686 | 2,023 | 1,952 | $1K | |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 188 | 185 | $949.23 |
| 90620 | 381 | 369 | $901.00 | |
| 0124A | 28 | 28 | $719.69 | |
| 90834 | Psychotherapy, 45 minutes with patient | 106 | 72 | $660.26 |
| 82962 | 1,374 | 1,298 | $626.01 | |
| 0071A | 14 | 14 | $528.62 | |
| 85018 | 1,599 | 1,523 | $509.60 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 277 | 262 | $442.08 |
| 90832 | Psychotherapy, 30 minutes with patient | 54 | 44 | $425.26 |
| 90473 | 264 | 245 | $380.20 | |
| 90656 | 77 | 77 | $177.36 | |
| 90746 | 12 | 12 | $140.76 | |
| 90734 | 344 | 335 | $128.85 | |
| 36415 | Collection of venous blood by venipuncture | 247 | 229 | $128.50 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 60 | 59 | $118.08 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 63 | 56 | $77.02 |
| 87428 | 17 | 17 | $76.86 | |
| 90715 | 143 | 140 | $76.59 | |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 162 | 77 | $44.74 |
| 86703 | 35 | 35 | $34.05 | |
| 90672 | 274 | 254 | $26.88 | |
| 91300 | 208 | 195 | $0.00 | |
| 91312 | 14 | 14 | $0.00 | |
| 91307 | 80 | 72 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 452 | 406 | $0.00 |
| 91305 | 175 | 172 | $0.00 |