KIMES FAMILY DENTISTRY PLLC
NPI: 1538675103
· BOONEVILLE, AR 72927
· Dental Clinic/Center
· NPI assigned 12/19/2017
$187K
Total Medicaid Paid
Provider Details
| Authorized Official | KIMES, EMILY (DENTIST) |
| NPI Enumeration Date | 12/19/2017 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
114 |
$3K |
| 2019 |
730 |
$21K |
| 2020 |
708 |
$18K |
| 2021 |
656 |
$17K |
| 2022 |
1,477 |
$41K |
| 2023 |
1,417 |
$43K |
| 2024 |
1,516 |
$45K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,721 |
1,686 |
$42K |
| D1110 |
Prophylaxis - adult |
937 |
919 |
$42K |
| D0272 |
Bitewings - two radiographic images |
1,412 |
1,394 |
$30K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,574 |
1,548 |
$29K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
199 |
165 |
$15K |
| D1120 |
Prophylaxis - child |
380 |
373 |
$13K |
| D2140 |
|
87 |
71 |
$5K |
| D0330 |
Panoramic radiographic image |
105 |
99 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
164 |
163 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
39 |
39 |
$559.55 |