Dental
SLPD Cottonwood LLC
SLPD Cottonwood LLC was paid $87K by Medicaid between Jul 2021 and Nov 2024, across 8 billing codes. Its largest line is D1120, dental cleaning, child — 25% of everything it billed.
33Billing provider infoSLPD COTTONWOOD LLC
COTTONWOOD HEIGHTS, UT 84121
COTTONWOOD HEIGHTS, UT 84121
33aNPI1376044313assigned 02/26/2018
33bProvider typePediatric Dentist
28Total paid$87K
24GClaims3,473
24DCodes billed8
24AFirst – last monthJul 2021 – Nov 2024
Compared with peers
Next to other Pediatric Dentist providers in Utah
Rank by total paid#115 of 152
Median peer was paid$311K
This provider vs. median0.3×
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 | 382 | $8K | |
| 2022 | 896 | $21K | |
| 2023 | 1,451 | $39K | |
| 2024incomplete | 744 | $19K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 25% | 779 | 766 | $22K |
| D1206 | Topical application of fluoride varnish | 21% | 949 | 934 | $18K |
| D0272 | Bitewings - two radiographic images | 20% | 536 | 524 | $17K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 17% | 767 | 755 | $15K |
| D0220 | Intraoral - periapical first radiographic image | 14% | 270 | 262 | $12K |
| D0274 | Bitewings - four radiographic images | 1.6% | 39 | 39 | $1K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.1% | 109 | 103 | $928.48 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 24 | 24 | $634.68 |
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 officialGUSTAFSON, DAVID (OWNER/DENTIST)