Dental
Ellsworth, Jesse
Ellsworth, Jesse was paid $1.30M by Medicaid between Sep 2022 and Dec 2024, across 21 billing codes. Its largest line is D1120, dental cleaning, child — 13% of everything it billed.
33Billing provider infoELLSWORTH, JESSE
OAK RIDGE, TN 37830
OAK RIDGE, TN 37830
33aNPI1043662778assigned 07/06/2016
33bProvider typeDentist
28Total paid$1.30M
24GClaims47,241
24DCodes billed21
24AFirst – last monthSep 2022 – Dec 2024
Compared with peers
Next to other Dentist providers in Tennessee
Rank by total paid#21 of 242
Median peer was paid$164K
This provider vs. median7.9×
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 | 1,351 | $44K | |
| 2023 | 19,206 | $553K | |
| 2024incomplete | 26,684 | $703K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 13% | 5,218 | 5,032 | $168K |
| D1208 | Topical application of fluoride, excluding varnish | 11% | 7,162 | 6,905 | $147K |
| D1110 | Prophylaxis - adult | 9.7% | 3,027 | 2,935 | $126K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.5% | 5,137 | 4,982 | $123K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.2% | 4,323 | 4,158 | $119K |
| D1352 | 9.1% | 4,145 | 800 | $118K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 6.3% | 1,162 | 876 | $81K |
| D0330 | Panoramic radiographic image | 5.4% | 1,969 | 1,873 | $71K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 5.0% | 2,332 | 2,110 | $65K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.8% | 1,064 | 780 | $62K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 3.5% | 415 | 242 | $45K |
| D0272 | Bitewings - two radiographic images | 3.4% | 2,589 | 2,499 | $44K |
9 more codes
| D0274 | Bitewings - four radiographic images | 3.4% | 1,705 | $44K |
| D1354 | 2.8% | 4,433 | $37K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 851 | $10K |
| D0140 | Limited oral evaluation - problem focused | <1% | 469 | $10K |
| D1206 | Topical application of fluoride varnish | <1% | 433 | $9K |
| D2999 | <1% | 385 | $9K | |
| D1351 | Sealant - per tooth | <1% | 242 | $7K |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 92 | $4K |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 88 | $779.55 |
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.