NPI: 1982764643 · GRAND RAPIDS, MI 49504 · Social Worker · NPI assigned 12/11/2006
Authorized official BLACKMON, TASHA controls 20+ related entities in our dataset. Read more
| Authorized Official | BLACKMON, TASHA (CEO) |
| NPI Enumeration Date | 12/11/2006 |
Other providers sharing the same authorized official: BLACKMON, TASHA
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,529 | $80K |
| 2019 | 1,585 | $49K |
| 2020 | 346 | $11K |
| 2021 | 145 | $4K |
| 2022 | 725 | $20K |
| 2023 | 1,262 | $41K |
| 2024 | 859 | $28K |
| 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 | 1,793 | 1,503 | $121K |
| D1110 | Prophylaxis - adult | 704 | 704 | $34K |
| 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 | 326 | 172 | $23K |
| D0120 | Periodic oral evaluation - established patient | 443 | 443 | $12K |
| 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 | 205 | 205 | $12K |
| D0210 | Intraoral - complete series of radiographic images | 159 | 159 | $11K |
| D1206 | Topical application of fluoride varnish | 479 | 479 | $7K |
| D0274 | Bitewings - four radiographic images | 150 | 150 | $5K |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 814 | 720 | $3K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 16 | 12 | $2K |
| D1351 | Sealant - per tooth | 58 | 12 | $725.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 14 | 14 | $690.75 |
| 96127 | 1,213 | 1,105 | $551.50 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 244 | 232 | $420.91 |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 112 | 100 | $301.10 |
| 99384 | 13 | 13 | $198.74 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 105 | 94 | $196.48 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 40 | 40 | $160.78 |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 41 | 41 | $112.14 |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 46 | 26 | $67.11 |
| 90472 | Immunization administration, each additional vaccine (list separately) | 40 | 40 | $44.13 |
| 99173 | 273 | 273 | $0.00 | |
| 90686 | 94 | 94 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 53 | 53 | $0.00 |
| 90620 | 16 | 16 | $0.00 |