Carl E. Smith, M.D., F.A.A.P., PLLC
Carl E. Smith, M.D., F.A.A.P., PLLC was paid $640K by Medicaid between Jan 2018 and Dec 2024, across 24 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 68% of everything it billed.
33Billing provider infoCARL E. SMITH, M.D., F.A.A.P., PLLC
HARLAN, KY 40831
HARLAN, KY 40831
33aNPI1053427286assigned 08/21/2006
33bProvider typeSpecialist
28Total paid$640K
24GClaims16,675
24DCodes billed24
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Specialist providers in Kentucky
Rank by total paid#15 of 73
Median peer was paid$107K
This provider vs. median6.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 3,152 | $115K | |
| 2019 | 2,648 | $94K | |
| 2020 | 1,735 | $70K | |
| 2021 | 1,884 | $82K | |
| 2022 | 2,629 | $99K | |
| 2023 | 2,509 | $94K | |
| 2024incomplete | 2,118 | $86K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 68% | 9,908 | 6,813 | $438K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 8.6% | 895 | 841 | $55K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 7.7% | 565 | 501 | $49K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 3.6% | 545 | 480 | $23K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.9% | 1,188 | 547 | $19K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.8% | 701 | 609 | $18K |
| 99354 | 1.4% | 150 | 117 | $9K | |
| 87430 | 1.0% | 450 | 403 | $7K | |
| 87807 | <1% | 471 | 425 | $5K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 75 | 74 | $5K |
| 69210 | <1% | 186 | 165 | $4K | |
| 94664 | <1% | 274 | 253 | $3K |
12 more codes
| 80061 | Lipid panel | <1% | 108 | $2K |
| 80305 | <1% | 92 | $1K | |
| 92551 | <1% | 68 | $805.97 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 42 | $409.58 |
| 36416 | <1% | 393 | $409.32 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 12 | $386.91 |
| 92552 | <1% | 17 | $210.37 | |
| 85018 | <1% | 324 | $210.35 | |
| 83655 | <1% | 17 | $180.21 | |
| 90688 | <1% | 65 | $96.38 | |
| 82962 | <1% | 26 | $85.23 | |
| 90672 | 0% | 103 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSMITH, CARL (OWNER)
| Provider | Location | Paid |
|---|---|---|
| The Boothwyn Fire Company No 1 | Upper Chichester, PA | $355K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.