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    v1.0.28
    OpenPayerNPI Medicare & MedicaidJared Wolthuis
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    Jared Wolthuis — Billing Profile & Reimbursement Data

    NPI 1851583520 · Ogden, UT · Dentist

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    Jared Wolthuis is a dentist provider located in Ogden, Utah. This profile covers 0 Medicare and 14 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJared Wolthuis
    Address512 12th St
    CityOgden
    StateUT
    ZIP84404
    TaxonomyDentist
    NPI EnumeratedAugust 15, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$439.4K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D0120Periodic oral evaluation - established patient2,150$90$186.7K
    D0150Comprehensive oral evaluation – new or established patient720$100$70.7K
    D1120Prophylaxis–child2,560$20$40.9K
    D0272N/A1,740$10$19.2K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients2,690$10$18.9K
    D2150Amalgam - two surfaces, primary or permanent300$60$18.7K
    D0220Intraoral - periapical first radiographic image2,630$10$18.4K
    D1351Sealant - per tooth930$20$17.6K
    D2392Post 2 surface resin‑based composite150$90$13.3K
    D0274N/A540$20$10.8K

    Showing 1–10 of 14

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Utah median

    14 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D0120Periodic oral evaluation - established patient117470460$80$149.8K
    D1351Sealant - per tooth76190620$30$60.7K
    D2150Amalgam - two surfaces, primary or permanent110220290$60$45K
    D2392Post 2 surface resin‑based composite90170170$80$39.4K
    D0220Intraoral - periapical first radiographic image71440470$20$32.8K
    D0150Comprehensive oral evaluation – new or established patient49420110$100$30.8K
    D1120Prophylaxis–child94420440$20$30.7K
    D2140Amalgam - one surface, primary or permanent106170200$50$25.2K
    D0272N/A88310550$20$24.7K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients92430460$10$13.8K

    Showing 1–10 of 14

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Jared Wolthuis, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    R Ryan JohansenUTPediatric Dentistry$0$2.9M
    Rose Park Pediatric Dentistry, PCUTPediatric Dentistry$0$1.8M

    Nearby Providers

    Other providers in the same ZIP code as Jared Wolthuis, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Utah Schools For The Deaf And The BlindUTLocal Education Agency (LEA)$0$6M
    Gardens Retirement HomeUTAssisted Living Facility$0$5.2M
    Bristol Hospice - Utah, L.L.C.UTCommunity Based Hospice Care Agency$0$3.7M
    Cameron QuayleUTPediatric Dentistry$0$3.1M
    Utah Schools For The Deaf And The BlindUTLocal Education Agency (LEA)$0$2.5M
    Welltower Tenant Group, LLCUTAssisted Living Facility$0$2.2M
    Mountain View Pediatric Dentistry LLCUTDental Clinic/Center$0$987.7K
    Weber-morgan Early InterventionUTDevelopmentally Disabled Services Day Training Agency$0$720.5K
    Monarch TherapyUTCommunity/Behavioral Health Agency$0$602.1K
    Aloha Behavioral Consultants, Inc.UTClinical Social Worker$0$515.9K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Utah Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Utah Distribution
    Jared Wolthuis — 0 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah