NPI: 1700585189 · CLARE, MI 48617 · General Practice Dentistry · NPI assigned 02/24/2023
| Authorized Official | BURKE, PERRY (MEMBER) |
| NPI Enumeration Date | 02/24/2023 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 100 | $2K |
| 2024 | 163 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 59 | 59 | $3K |
| D1206 | Topical application of fluoride varnish | 83 | 83 | $2K |
| D0120 | Periodic oral evaluation - established patient | 76 | 75 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 29 | 29 | $525.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 16 | 16 | $176.00 |