Dental
Jacobsen, Matthew
Jacobsen, Matthew was paid $133K by Medicaid between Feb 2019 and Nov 2024, across 7 billing codes. Its largest line is D0120, dental checkup, returning patient — 52% of everything it billed.
33Billing provider infoJACOBSEN, MATTHEW
RIVERTON, UT 84096
RIVERTON, UT 84096
33aNPI1952659708assigned 08/28/2012
33bProvider typePediatric Dentist
28Total paid$133K
24GClaims5,343
24DCodes billed7
24AFirst – last monthFeb 2019 – Nov 2024
Compared with peers
Next to other Pediatric Dentist providers in Utah
Rank by total paid#103 of 152
Median peer was paid$311K
This provider vs. median0.4×
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 | |
|---|---|---|---|
| 2019 | 229 | $5K | |
| 2020 | 547 | $12K | |
| 2021 | 959 | $25K | |
| 2022 | 965 | $26K | |
| 2023 | 1,448 | $35K | |
| 2024incomplete | 1,195 | $31K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 52% | 1,023 | 1,020 | $69K |
| D1120 | Dental cleaning, childProphylaxis - child | 18% | 1,256 | 1,253 | $24K |
| D0272 | Bitewings - two radiographic images | 12% | 844 | 843 | $16K |
| D1206 | Topical application of fluoride varnish | 8.0% | 1,250 | 1,242 | $11K |
| D0150 | Comprehensive oral evaluation - new or established patient | 4.6% | 57 | 57 | $6K |
| D0220 | Intraoral - periapical first radiographic image | 3.4% | 496 | 496 | $5K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.2% | 417 | 379 | $3K |
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.