Jacobsen, Gary

Jacobsen, Gary was paid $229.49 by Medicaid between Feb 2020 and Feb 2020, across 1 billing code. Its largest line is D0120, dental checkup, returning patient — 100% of everything it billed.

33Billing provider infoJACOBSEN, GARY
INDIANOLA, IA 50125

33aNPI1205895166assigned 03/20/2006

33bProvider typeDentist

28Total paid$229.49

24GClaims12

24DCodes billed1

24AFirst – last monthFeb 2020 – Feb 2020

Compared with peers

Next to other Dentist providers in Iowa

Rank by total paid#260 of 268

Median peer was paid$26K

This provider vs. median0.0×

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
2020	12	$229.49

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	100%	12	12	$229.49

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.