Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

RODEO DENTAL SOUTHMOST PLLC

NPI: 1013217579 · BROWNSVILLE, TX 78521 · Pediatric Dentist · NPI assigned 10/29/2010

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more

$8.91M
Total Medicaid Paid
260,825
Total Claims
212,116
Beneficiaries
36
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKOUYOUMDJIAN, RAFFY (OWNER)
NPI Enumeration Date10/29/2010

Related Entities

Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY

ProviderCityStateTotal Paid
RODEO WESLACO DENTAL & ORTHODONTICS WESLACO TX $14.00M
RODEO DENTAL PHARR PLLC PHARR TX $10.70M
RODEO DENTAL SAN BENITO, PLLC SAN BENITO TX $10.54M
PASADENA DENTAL & ORTHODONTICS PLLC SOUTH HOUSTON TX $8.93M
FM KATY DENTAL AND ORTHODONTICS, PLLC FORT WORTH TX $8.87M
REAL SMILES FORT WORTH TX $7.68M
ELSA DENTAL AND ORTHODONTICS, PLLC FORT WORTH TX $7.40M
RODEO LAREDO DENTAL & ORTHODONTICS, PLLC LAREDO TX $6.12M
RODEO DENTAL CENTRAL PLLC BROWNSVILLE TX $6.08M
RUBEN TORRES DENTAL, PLLC BROWNSVILLE TX $5.21M
WACO DENTAL AND ORTHODONTICS, PLLC WACO TX $2.19M
CYPRESS POINT DENTAL AND ORTHODONTICS, PLLC HOUSTON TX $1.48M
KIRKWOOD DENTAL AND ORTHODONTICS, PLLC STAFFORD TX $1.18M
PEORIA ST. DENTAL AND ORTHODONTICS PLLC AURORA CO $949K
MIDLAND DENTAL AND ORTHODONTICS, PLLC MIDLAND TX $463K
CASA GRANDE DENTAL AND ORTHODONTICS LLC CASA GRANDE AZ $199K
PHOENIX DENTAL AND ORTHODONTICS, PLLC PHOENIX AZ $86K
TUCSON DENTAL AND ORTHODONTICS TUCSON AZ $45K
290 CROSSING DENTAL AND ORTHODONTICS PLLC HOUSTON TX $16K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 418 $5K
2019 935 $14K
2020 7,305 $272K
2021 67,475 $2.32M
2022 69,078 $2.41M
2023 66,648 $2.28M
2024 48,966 $1.61M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 13,816 6,735 $1.38M
D2391 Resin-based composite - one surface, posterior, primary or permanent 12,466 6,590 $965K
D2930 Prefabricated stainless steel crown - primary tooth 5,441 1,714 $790K
D0145 Oral evaluation for a patient under three years of age 5,345 5,314 $748K
D1351 Sealant - per tooth 27,433 8,123 $727K
D0120 Periodic oral evaluation - established patient 21,225 21,058 $600K
D1120 Prophylaxis - child 13,869 13,758 $496K
D1110 Prophylaxis - adult 8,392 8,332 $449K
D7240 Removal of impacted tooth - completely bony 1,477 486 $405K
D1208 Topical application of fluoride, excluding varnish 23,185 22,990 $332K
D0230 Intraoral - periapical each additional radiographic image 31,005 22,303 $327K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 12,168 11,817 $319K
D0274 Bitewings - four radiographic images 8,939 8,871 $287K
D0220 Intraoral - periapical first radiographic image 23,653 23,343 $270K
D0272 Bitewings - two radiographic images 10,201 10,130 $227K
D9248 1,555 1,523 $181K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 595 379 $62K
D0150 Comprehensive oral evaluation - new or established patient 1,792 1,753 $60K
D0210 Intraoral - complete series of radiographic images 850 835 $51K
D2934 319 106 $45K
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 505 164 $41K
D0330 Panoramic radiographic image 1,537 1,525 $36K
D0160 2,146 2,112 $31K
D2330 358 230 $26K
D0140 Limited oral evaluation - problem focused 1,200 1,162 $20K
D7111 1,098 816 $12K
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment 103 58 $6K
D2331 43 27 $4K
D9222 58 58 $4K
D1330 259 258 $3K
D7140 Extraction, erupted tooth or exposed root 29 15 $2K
D9612 31 29 $893.00
D0350 62 61 $848.72
D0273 15 15 $319.11
D0270 31 31 $151.20
D0603 29,624 29,395 $0.02