Jacobson, David

Jacobson, David was paid $46K by Medicaid between Mar 2023 and Dec 2024, across 7 billing codes. Its largest line is D1120, dental cleaning, child — 38% of everything it billed.

33Billing provider infoJACOBSON, DAVID
SARATOGA SPRINGS, UT 84045

33aNPI1386924785assigned 08/17/2011

33bProvider typePediatric Dentist

28Total paid$46K

24GClaims1,899

24DCodes billed7

24AFirst – last monthMar 2023 – Dec 2024

Compared with peers

Next to other Pediatric Dentist providers in Utah

Rank by total paid#131 of 152

Median peer was paid$311K

This provider vs. median0.1×

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
2023	618	$15K
2024incomplete	1,281	$31K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1120	Dental cleaning, childProphylaxis - child	38%	440	440	$17K
D1206	Topical application of fluoride varnish	16%	417	414	$7K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	12%	223	222	$5K
D0150	Comprehensive oral evaluation - new or established patient	11%	152	150	$5K
D0272	Bitewings - two radiographic images	11%	207	207	$5K
D0220	Intraoral - periapical first radiographic image	6.8%	230	227	$3K
D0230	Intraoral - periapical each additional radiographic image	5.2%	230	212	$2K

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.