Dental
Long, Ethan
Long, Ethan was paid $133K by Medicaid between Jan 2018 and Mar 2020, across 13 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 29% of everything it billed.
33Billing provider infoLONG, ETHAN
KODAK, TN 37764
KODAK, TN 37764
33aNPI1144679523assigned 06/07/2016
33bProvider typeDentist
28Total paid$133K
24GClaims3,803
24DCodes billed13
24AFirst – last monthJan 2018 – Mar 2020
Compared with peers
Next to other Dentist providers in Tennessee
Rank by total paid#136 of 242
Median peer was paid$164K
This provider vs. median0.8×
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 | 1,920 | $74K | |
| 2019 | 1,738 | $55K | |
| 2020 | 145 | $4K |
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 | 29% | 535 | 316 | $38K |
| D1110 | Prophylaxis - adult | 13% | 427 | 418 | $18K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 13% | 274 | 165 | $17K |
| D1208 | Topical application of fluoride, excluding varnish | 9.8% | 658 | 645 | $13K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 8.8% | 412 | 390 | $12K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.2% | 424 | 414 | $10K |
| D0274 | Bitewings - four radiographic images | 6.8% | 398 | 388 | $9K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.8% | 225 | 222 | $6K |
| D0330 | Panoramic radiographic image | 3.4% | 161 | 158 | $4K |
| D1120 | Dental cleaning, childProphylaxis - child | 2.0% | 80 | 77 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 1.4% | 155 | 151 | $2K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | <1% | 15 | 13 | $1K |
1 more codes
| D0272 | Bitewings - two radiographic images | <1% | 39 | $667.08 |
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.