NPI: 1073270575 · HOUSTON, TX 77090 · General Practice Dentistry · NPI assigned 11/19/2021
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 11/19/2021 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 2,249 | $69K |
| 2023 | 20,782 | $724K |
| 2024 | 21,216 | $683K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 2,522 | 387 | $337K |
| D0145 | Oral evaluation for a patient under three years of age | 1,179 | 1,166 | $159K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1,555 | 587 | $150K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1,058 | 207 | $82K |
| D0230 | Intraoral - periapical each additional radiographic image | 8,679 | 3,537 | $78K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2,446 | 2,383 | $78K |
| D1120 | Prophylaxis - child | 2,405 | 2,356 | $78K |
| D0210 | Intraoral - complete series of radiographic images | 858 | 850 | $57K |
| D1351 | Sealant - per tooth | 2,057 | 425 | $49K |
| D1110 | Prophylaxis - adult | 953 | 936 | $47K |
| D0120 | Periodic oral evaluation - established patient | 1,666 | 1,636 | $46K |
| D1208 | Topical application of fluoride, excluding varnish | 3,487 | 3,418 | $45K |
| D0220 | Intraoral - periapical first radiographic image | 3,843 | 3,761 | $36K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 334 | 159 | $34K |
| D2934 | 219 | 53 | $32K | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 390 | 207 | $28K |
| D0274 | Bitewings - four radiographic images | 912 | 894 | $25K |
| D9248 | 195 | 189 | $21K | |
| D0330 | Panoramic radiographic image | 738 | 731 | $21K |
| D0272 | Bitewings - two radiographic images | 1,086 | 1,074 | $16K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 266 | 107 | $14K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 382 | 355 | $10K |
| D0160 | 671 | 624 | $9K | |
| D9222 | 113 | 107 | $8K | |
| D7140 | Extraction, erupted tooth or exposed root | 125 | 61 | $7K |
| D0140 | Limited oral evaluation - problem focused | 160 | 154 | $3K |
| D9612 | 124 | 102 | $3K | |
| D1330 | 261 | 245 | $2K | |
| D0603 | 5,563 | 5,480 | $45.43 |