Dental
Pak, Ethelyn
Pak, Ethelyn was paid $359K by Medicaid between Apr 2018 and Apr 2024, across 16 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 18% of everything it billed.
33Billing provider infoPAK, ETHELYN
SMYRNA, TN 37167
SMYRNA, TN 37167
33aNPI1083168538assigned 08/12/2016
33bProvider typeDentist
28Total paid$359K
24GClaims12,217
24DCodes billed16
24AFirst – last monthApr 2018 – Apr 2024
Compared with peers
Next to other Dentist providers in Tennessee
Rank by total paid#82 of 242
Median peer was paid$164K
This provider vs. median2.2×
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 | |
|---|---|---|---|
| 2018 | 1,590 | $52K | |
| 2019 | 2,804 | $77K | |
| 2020 | 1,763 | $49K | |
| 2021 | 2,035 | $67K | |
| 2022 | 1,779 | $53K | |
| 2023 | 1,798 | $49K | |
| 2024incomplete | 448 | $12K |
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 | 18% | 954 | 491 | $66K |
| D1120 | Dental cleaning, childProphylaxis - child | 17% | 1,886 | 1,870 | $62K |
| D1206 | Topical application of fluoride varnish | 16% | 2,946 | 2,914 | $58K |
| D1110 | Prophylaxis - adult | 16% | 1,443 | 1,417 | $57K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 16% | 2,437 | 2,408 | $57K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.1% | 192 | 98 | $11K |
| D0272 | Bitewings - two radiographic images | 2.5% | 530 | 526 | $9K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.2% | 290 | 286 | $8K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.0% | 92 | 51 | $7K |
| D0274 | Bitewings - four radiographic images | 2.0% | 307 | 299 | $7K |
| D0220 | Intraoral - periapical first radiographic image | 1.5% | 488 | 463 | $5K |
| D0210 | Intraoral - complete series of radiographic images | 1.3% | 102 | 102 | $5K |
4 more codes
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.