HANSEN, GENTRY
NPI: 1235497975
· SIOUX CITY, IA 51106
· Oral and Maxillofacial Surgery (Dentist)
· NPI assigned 05/01/2012
$455K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
565 |
$52K |
| 2023 |
3,086 |
$352K |
| 2024 |
620 |
$52K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,222 |
389 |
$279K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,153 |
491 |
$89K |
| D9222 |
|
506 |
491 |
$43K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
234 |
95 |
$22K |
| D0140 |
Limited oral evaluation - problem focused |
644 |
617 |
$15K |
| D9610 |
|
485 |
472 |
$5K |
| D0330 |
Panoramic radiographic image |
27 |
27 |
$1K |