KELVIN B. SMITH, DDS, LLC
NPI: 1003058801
· BALTIMORE, MD 21244
· General Practice Dentistry
· NPI assigned 03/25/2009
$471K
Total Medicaid Paid
Provider Details
| Authorized Official | SMITH, KELVIN (MANAGING MEMBER) |
| NPI Enumeration Date | 03/25/2009 |
Related Entities
Other providers sharing the same authorized official: SMITH, KELVIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,688 |
$89K |
| 2019 |
2,525 |
$80K |
| 2020 |
2,046 |
$65K |
| 2021 |
1,725 |
$57K |
| 2022 |
1,946 |
$65K |
| 2023 |
1,653 |
$58K |
| 2024 |
1,523 |
$57K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
3,884 |
3,840 |
$114K |
| D1120 |
Prophylaxis - child |
2,494 |
2,472 |
$108K |
| D1110 |
Prophylaxis - adult |
1,705 |
1,678 |
$101K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,957 |
3,907 |
$90K |
| D0274 |
Bitewings - four radiographic images |
1,091 |
1,079 |
$24K |
| D0330 |
Panoramic radiographic image |
366 |
365 |
$16K |
| D1351 |
Sealant - per tooth |
388 |
63 |
$13K |
| D0272 |
Bitewings - two radiographic images |
161 |
160 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
22 |
14 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
25 |
25 |
$1K |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$323.96 |