Clinic
Kathleen Ellsworth DDS PC
Kathleen Ellsworth DDS PC was paid $1.06M by Medicaid between May 2022 and Dec 2024, across 23 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 13% of everything it billed.
33Billing provider infoKATHLEEN ELLSWORTH DDS PC
SARANAC, MI 48881
SARANAC, MI 48881
33aNPI1457092926assigned 04/06/2022
33bProvider typeDental Clinic/Center
28Total paid$1.06M
24GClaims25,994
24DCodes billed23
24AFirst – last monthMay 2022 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Michigan
Rank by total paid#41 of 431
Median peer was paid$24K
This provider vs. median44×
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 | 5,642 | $234K | |
| 2023 | 11,252 | $446K | |
| 2024incomplete | 9,100 | $382K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 13% | 834 | 479 | $142K |
| D1352 | 12% | 1,802 | 581 | $127K | |
| D1351 | Sealant - per tooth | 10.0% | 3,479 | 633 | $106K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.6% | 869 | 573 | $102K |
| D1354 | 9.6% | 4,248 | 1,141 | $101K | |
| D7140 | Extraction, erupted tooth or exposed root | 9.4% | 1,154 | 570 | $99K |
| D1120 | Dental cleaning, childProphylaxis - child | 7.5% | 1,951 | 1,950 | $79K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.1% | 1,582 | 1,582 | $44K |
| D1206 | Topical application of fluoride varnish | 3.6% | 1,347 | 1,347 | $38K |
| D0220 | Intraoral - periapical first radiographic image | 3.1% | 1,978 | 1,957 | $33K |
| D0230 | Intraoral - periapical each additional radiographic image | 3.1% | 3,406 | 1,548 | $33K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.9% | 212 | 170 | $31K |
11 more codes
| D0140 | Limited oral evaluation - problem focused | 2.6% | 636 | $28K |
| D1110 | Prophylaxis - adult | 2.0% | 431 | $21K |
| D1510 | 1.7% | 101 | $18K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.7% | 152 | $18K |
| D1208 | Topical application of fluoride, excluding varnish | 1.4% | 685 | $15K |
| D0272 | Bitewings - two radiographic images | 1.3% | 597 | $14K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 74 | $5K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 77 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 34 | $3K |
| D0274 | Bitewings - four radiographic images | <1% | 25 | $730.97 |
| D0603 | 0% | 320 | $0.00 |
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.
From NPPES
Who's on the registration
Authorized officialELLSWORTH, KATHLEEN (DENTIST)