5TH Ave Smile LLC

5TH Ave Smile LLC was paid $67K by Medicaid between Mar 2018 and Apr 2023, across 11 billing codes. Its largest line is D1110, Prophylaxis - adult — 48% of everything it billed.

33Billing provider info5TH AVE SMILE LLC
AURORA, CO 80010

33aNPI1144742628assigned 07/17/2017

33bProvider typeDental Hygienist

28Total paid$67K

24GClaims1,911

24DCodes billed11

24AFirst – last monthMar 2018 – Apr 2023

Compared with peers

Next to other Dental Hygienist providers in Colorado

Rank by total paid#24 of 69

Median peer was paid$23K

This provider vs. median2.8×

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	60	$2K
2019	163	$5K
2020	250	$11K
2021	745	$26K
2022	549	$18K
2023	144	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	48%	782	779	$32K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	17%	513	511	$12K
D2391	Resin-based composite - one surface, posterior, primary or permanent	10%	66	29	$7K
D0180		7.1%	114	114	$5K
D0274	Bitewings - four radiographic images	6.9%	158	158	$5K
D0150	Comprehensive oral evaluation - new or established patient	4.9%	86	86	$3K
D0210	Intraoral - complete series of radiographic images	1.6%	13	13	$1K
D0230	Intraoral - periapical each additional radiographic image	1.2%	65	65	$797.17
D0220	Intraoral - periapical first radiographic image	1.2%	65	65	$797.17
D1206	Topical application of fluoride varnish	<1%	37	37	$606.55
D1120	Dental cleaning, childProphylaxis - child	<1%	12	12	$468.36

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 officialOSEI TUTU, JUSTICE (DENTAL HYGIENIST)