Li, Horton

Li, Horton was paid $208K by Medicaid between Jun 2023 and Dec 2024, across 18 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 14% of everything it billed.

33Billing provider infoLI, HORTON
LEBANON, TN 37087

33aNPI1083142483assigned 05/30/2017

33bProvider typePediatric Dentist

28Total paid$208K

24GClaims6,448

24DCodes billed18

24AFirst – last monthJun 2023 – Dec 2024

Compared with peers

Next to other Pediatric Dentist providers in Tennessee

Rank by total paid#75 of 112

Median peer was paid$1.03M

This provider vs. median0.2×

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	2,030	$66K
2024incomplete	4,418	$143K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	14%	396	202	$29K
D1120	Dental cleaning, childProphylaxis - child	13%	819	815	$27K
D2391	Resin-based composite - one surface, posterior, primary or permanent	11%	391	226	$22K
D1206	Topical application of fluoride varnish	11%	1,062	1,056	$22K
D0150	Comprehensive oral evaluation - new or established patient	7.8%	553	552	$16K
D1351	Sealant - per tooth	7.2%	565	169	$15K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	7.1%	662	653	$15K
D1110	Prophylaxis - adult	6.1%	342	336	$13K
D0330	Panoramic radiographic image	5.7%	409	406	$12K
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	4.0%	290	279	$8K
D9248		3.9%	92	88	$8K
D2930	Prefabricated stainless steel crown - primary tooth	3.6%	77	29	$8K

6 more codes

D0272	Bitewings - two radiographic images	2.5%	364	$5K
D0274	Bitewings - four radiographic images	2.1%	224	$4K
D7140	Extraction, erupted tooth or exposed root	<1%	31	$2K
D0140	Limited oral evaluation - problem focused	<1%	69	$2K
D0220	Intraoral - periapical first radiographic image	<1%	74	$743.35
D3120		<1%	28	$78.28

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.