Clinic
Country Creek Dental PLLC
Country Creek Dental PLLC was paid $465K by Medicaid between Mar 2018 and Dec 2024, across 14 billing codes. Its largest line is D1110, Prophylaxis - adult — 23% of everything it billed.
33Billing provider infoCOUNTRY CREEK DENTAL PLLC
ALCOA, TN 37701
ALCOA, TN 37701
33aNPI1306357447assigned 10/16/2017
33bProvider typeDental Clinic/Center
28Total paid$465K
24GClaims17,403
24DCodes billed14
24AFirst – last monthMar 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Tennessee
Rank by total paid#16 of 40
Median peer was paid$259K
This provider vs. median1.8×
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 | 2,588 | $67K | |
| 2019 | 3,947 | $103K | |
| 2020 | 3,261 | $88K | |
| 2021 | 3,097 | $83K | |
| 2022 | 2,331 | $62K | |
| 2023 | 1,412 | $40K | |
| 2024incomplete | 767 | $22K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 23% | 2,610 | 2,546 | $108K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 18% | 3,631 | 3,555 | $85K |
| D1206 | Topical application of fluoride varnish | 10% | 2,344 | 2,292 | $47K |
| D1120 | Dental cleaning, childProphylaxis - child | 10.0% | 1,437 | 1,407 | $46K |
| D0274 | Bitewings - four radiographic images | 9.1% | 1,603 | 1,556 | $42K |
| D1208 | Topical application of fluoride, excluding varnish | 7.1% | 1,606 | 1,568 | $33K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5.1% | 420 | 291 | $24K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 3.5% | 229 | 148 | $16K |
| D0330 | Panoramic radiographic image | 2.9% | 384 | 374 | $13K |
| D1351 | Sealant - per tooth | 2.8% | 475 | 159 | $13K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.4% | 393 | 380 | $11K |
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 938 | 896 | $10K |
2 more codes
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 officialLA MONICA, NATHAN (DENTIST)