Dental
Jacobsen, Eric
Jacobsen, Eric was paid $128K by Medicaid between Jan 2018 and Sep 2021, across 15 billing codes. Its largest line is D1120, dental cleaning, child — 37% of everything it billed.
33Billing provider infoJACOBSEN, ERIC
PHOENIX, AZ 85015
PHOENIX, AZ 85015
33aNPI1720241052assigned 07/07/2008
33bProvider typePediatric Dentist
28Total paid$128K
24GClaims5,100
24DCodes billed15
24AFirst – last monthJan 2018 – Sep 2021
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#68 of 223
Median peer was paid$24K
This provider vs. median5.5×
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 | 3,513 | $91K | |
| 2019 | 777 | $19K | |
| 2020 | 573 | $12K | |
| 2021 | 237 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 37% | 1,286 | 1,269 | $48K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 27% | 1,353 | 1,336 | $34K |
| D1208 | Topical application of fluoride, excluding varnish | 13% | 1,059 | 1,044 | $17K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 9.0% | 194 | 101 | $12K |
| D0272 | Bitewings - two radiographic images | 5.2% | 438 | 434 | $7K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 3.1% | 177 | 166 | $4K |
| D1206 | Topical application of fluoride varnish | 1.2% | 94 | 92 | $2K |
| D0140 | Limited oral evaluation - problem focused | 1.0% | 42 | 41 | $1K |
| D1351 | Sealant - per tooth | 1.0% | 46 | 13 | $1K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 19 | 13 | $904.00 |
| D1999 | <1% | 153 | 142 | $693.00 | |
| D0603 | <1% | 65 | 65 | $671.00 |
3 more codes
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.