CRYSTAL CLEAR FAMILY DENTISTRY
NPI: 1659156719
· SMYRNA, TN 37167
· Dentist
· NPI assigned 08/28/2023
Provider Details
| Authorized Official | MEKONNEN, SARAH (CEO/OWNER) |
| NPI Enumeration Date | 08/28/2023 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
265 |
$4K |
| 2024 |
479 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
290 |
56 |
$14K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
45 |
12 |
$3K |
| D1110 |
Prophylaxis - adult |
82 |
70 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
71 |
62 |
$2K |
| D1206 |
Topical application of fluoride varnish |
112 |
89 |
$2K |
| D0274 |
Bitewings - four radiographic images |
85 |
67 |
$1K |
| D1330 |
|
59 |
45 |
$0.00 |