Dental
Crystal Smile, PLLC
Crystal Smile, PLLC was paid $1K by Medicaid between Sep 2022 and Dec 2023, across 3 billing codes. Its largest line is D1110, Prophylaxis - adult — 100% of everything it billed.
33Billing provider infoCRYSTAL SMILE, PLLC
ARLINGTON, VA 22202
ARLINGTON, VA 22202
33aNPI1639724461assigned 08/08/2019
33bProvider typeGeneral Practice Dentistry
28Total paid$1K
24GClaims91
24DCodes billed3
24AFirst – last monthSep 2022 – Dec 2023
Compared with peers
Next to other General Practice Dentistry providers in Virginia
Rank by total paid#440 of 549
Median peer was paid$29K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2022 | 13 | $599.34 | |
| 2023 | 78 | $736.20 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 100% | 53 | 53 | $1K |
| D0274 | Bitewings - four radiographic images | 0% | 26 | 26 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 12 | 12 | $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 officialFAVAGEHI, JASON (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Jason Farr Favagehi DDS III PC | Chantilly, VA | $34K |
| Crystal City Dental Arts Center | Arlington, VA | $13K |
| Jason Farr Favagehi DDC PC | Vienna, VA | $12K |
| Jason F Favagehi DDS PC | Arlington, VA | $3K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.