Crystal Clear Family Dentistry

Crystal Clear Family Dentistry was paid $24K by Medicaid between Sep 2023 and Sep 2024, across 7 billing codes. Its largest line is D2391, Resin-based composite - one surface, posterior, primary or permanent — 58% of everything it billed.

33Billing provider infoCRYSTAL CLEAR FAMILY DENTISTRY
SMYRNA, TN 37167

33aNPI1659156719assigned 08/28/2023

33bProvider typeDentist

28Total paid$24K

24GClaims744

24DCodes billed7

24AFirst – last monthSep 2023 – Sep 2024

Compared with peers

Next to other Dentist providers in Tennessee

Rank by total paid#198 of 242

Median peer was paid$164K

This provider vs. median0.1×

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
2023	265	$4K
2024incomplete	479	$20K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2391	Resin-based composite - one surface, posterior, primary or permanent	58%	290	56	$14K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	12%	45	12	$3K
D1110	Prophylaxis - adult	10%	82	70	$3K
D0150	Comprehensive oral evaluation - new or established patient	6.9%	71	62	$2K
D1206	Topical application of fluoride varnish	6.4%	112	89	$2K
D0274	Bitewings - four radiographic images	5.6%	85	67	$1K
D1330		0%	59	45	$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 officialMEKONNEN, SARAH (CEO/OWNER)