ARTHUR S JIMENEZ DDS PA
NPI: 1053759720
· WICHITA, KS 67208
· Dentist
· NPI assigned 06/04/2013
Provider Details
| Authorized Official | JIMENEZ, ARTHUR (DENTIST) |
| NPI Enumeration Date | 06/04/2013 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
88 |
$2K |
| 2019 |
54 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
75 |
74 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
27 |
27 |
$459.00 |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$410.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$348.00 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$330.00 |