Dental
Ettelbrick, Kelli
Ettelbrick, Kelli was paid $5K by Medicaid between Mar 2021 and May 2023, across 6 billing codes. Its largest line is D0120, dental checkup, returning patient — 33% of everything it billed.
33Billing provider infoETTELBRICK, KELLI
FRISCO, TX 75034
FRISCO, TX 75034
33aNPI1578505038assigned 06/11/2006
33bProvider typePediatric Dentist
28Total paid$5K
24GClaims317
24DCodes billed6
24AFirst – last monthMar 2021 – May 2023
Compared with peers
Next to other Pediatric Dentist providers in Texas
Rank by total paid#600 of 693
Median peer was paid$252K
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2021 | 54 | $1K | |
| 2022 | 86 | $1K | |
| 2023 | 177 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 33% | 68 | 62 | $2K |
| D1206 | Topical application of fluoride varnish | 32% | 121 | 115 | $2K |
| D1120 | Dental cleaning, childProphylaxis - child | 29% | 47 | 44 | $1K |
| D0220 | Intraoral - periapical first radiographic image | 3.4% | 16 | 14 | $175.84 |
| D0230 | Intraoral - periapical each additional radiographic image | 3.4% | 16 | 14 | $172.65 |
| D0602 | 0% | 49 | 47 | $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.