Roth, David

Roth, David was paid $203K by Medicaid between Jan 2018 and Dec 2024, across 11 billing codes. Its largest line is D0120, dental checkup, returning patient — 60% of everything it billed.

33Billing provider infoROTH, DAVID
SOUTH JORDAN, UT 84095

33aNPI1285685594assigned 05/12/2006

33bProvider typePediatric Dentist

28Total paid$203K

24GClaims6,353

24DCodes billed11

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Pediatric Dentist providers in Utah

Rank by total paid#93 of 152

Median peer was paid$311K

This provider vs. median0.7×

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	1,381	$33K
2019	1,030	$32K
2020	928	$41K
2021	571	$20K
2022	135	$7K
2023	1,302	$40K
2024incomplete	1,006	$30K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	60%	1,786	1,761	$121K
D1120	Dental cleaning, childProphylaxis - child	18%	1,610	1,586	$37K
D0272	Bitewings - two radiographic images	12%	1,185	1,172	$24K
D1206	Topical application of fluoride varnish	6.5%	1,572	1,551	$13K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	1.4%	28	12	$3K
D0150	Comprehensive oral evaluation - new or established patient	<1%	14	14	$1K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	19	13	$1K
D0274	Bitewings - four radiographic images	<1%	37	37	$968.96
D0220	Intraoral - periapical first radiographic image	<1%	55	53	$757.46
D1110	Prophylaxis - adult	<1%	15	15	$256.00
D9230	Inhalation of nitrous oxide / analgesia, anxiolysis	0%	32	29	$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.