GATEWAY FAMILY DENTAL, LLC
NPI: 1467751990
· LOWELL, MA 01852
· General Practice Dentistry
· NPI assigned 03/23/2011
$185K
Total Medicaid Paid
Provider Details
| Authorized Official | CHUOP, SERENA (DENTIST/OWNER) |
| NPI Enumeration Date | 03/23/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
953 |
$36K |
| 2019 |
791 |
$29K |
| 2020 |
731 |
$26K |
| 2021 |
621 |
$23K |
| 2022 |
624 |
$28K |
| 2023 |
696 |
$29K |
| 2024 |
333 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,190 |
1,186 |
$70K |
| D0120 |
Periodic oral evaluation - established patient |
1,650 |
1,647 |
$43K |
| D0274 |
Bitewings - four radiographic images |
900 |
899 |
$36K |
| D1208 |
Topical application of fluoride, excluding varnish |
793 |
792 |
$23K |
| D1120 |
Prophylaxis - child |
139 |
139 |
$7K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
40 |
24 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
18 |
12 |
$2K |
| D1999 |
|
19 |
17 |
$0.00 |