GERVASI, JOHN
NPI: 1255909701
· OREM, UT 84097
· General Practice Dentistry
· NPI assigned 06/11/2021
$934.29
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
26 |
$934.29 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
13 |
13 |
$558.72 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$375.57 |