Samuel L. Koth, DDS, PC

Samuel L. Koth, DDS, PC was paid $84K by Medicaid between Jan 2018 and Nov 2024, across 8 billing codes. Its largest line is D0120, dental checkup, returning patient — 34% of everything it billed.

33Billing provider infoSAMUEL L. KOTH, DDS, PC
ROCK VALLEY, IA 51247

33aNPI1760734263assigned 10/08/2012

33bProvider typeGeneral Practice Dentistry

28Total paid$84K

24GClaims3,434

24DCodes billed8

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other General Practice Dentistry providers in Iowa

Rank by total paid#121 of 437

Median peer was paid$22K

This provider vs. median3.8×

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	808	$19K
2019	578	$13K
2020	408	$9K
2021	548	$13K
2022	538	$14K
2023	360	$10K
2024incomplete	194	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	34%	1,350	1,292	$29K
D1110	Prophylaxis - adult	23%	513	500	$19K
D1120	Dental cleaning, childProphylaxis - child	22%	587	562	$18K
D1206	Topical application of fluoride varnish	19%	911	863	$16K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	22	12	$838.72
D0274	Bitewings - four radiographic images	<1%	24	24	$491.18
D0330	Panoramic radiographic image	<1%	12	12	$460.50
D0272	Bitewings - two radiographic images	<1%	15	15	$336.22

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 officialKOTH, SAMUEL (DENTIST/PRESIDENT)