NPI: 1114699089 · WACO, TX 76710 · General Practice Dentistry · NPI assigned 09/29/2021
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 09/29/2021 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 11,225 | $294K |
| 2023 | 31,918 | $943K |
| 2024 | 31,882 | $957K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 2,269 | 459 | $316K |
| D0145 | Oral evaluation for a patient under three years of age | 2,102 | 2,086 | $289K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1,839 | 945 | $177K |
| D1120 | Prophylaxis - child | 4,805 | 4,740 | $166K |
| D1351 | Sealant - per tooth | 5,706 | 984 | $142K |
| D0230 | Intraoral - periapical each additional radiographic image | 14,369 | 6,321 | $134K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3,194 | 3,099 | $104K |
| D0120 | Periodic oral evaluation - established patient | 3,591 | 3,557 | $99K |
| D1208 | Topical application of fluoride, excluding varnish | 6,463 | 6,363 | $90K |
| D1110 | Prophylaxis - adult | 1,701 | 1,681 | $86K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 970 | 549 | $71K |
| D0220 | Intraoral - periapical first radiographic image | 6,827 | 6,666 | $67K |
| D7240 | Removal of impacted tooth - completely bony | 218 | 68 | $59K |
| D0210 | Intraoral - complete series of radiographic images | 928 | 908 | $59K |
| D0274 | Bitewings - four radiographic images | 1,935 | 1,913 | $53K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1,747 | 1,594 | $44K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 549 | 168 | $43K |
| D0272 | Bitewings - two radiographic images | 2,282 | 2,261 | $41K |
| D0330 | Panoramic radiographic image | 1,269 | 1,238 | $35K |
| D9248 | 228 | 223 | $26K | |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 401 | 203 | $19K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 194 | 112 | $19K |
| D9222 | 214 | 205 | $14K | |
| D0140 | Limited oral evaluation - problem focused | 654 | 636 | $12K |
| D0160 | 711 | 699 | $10K | |
| D1330 | 577 | 556 | $6K | |
| D9612 | 158 | 148 | $4K | |
| D2934 | 28 | 13 | $4K | |
| D7140 | Extraction, erupted tooth or exposed root | 63 | 36 | $3K |
| D7111 | 49 | 37 | $512.59 | |
| D0270 | 40 | 39 | $171.50 | |
| D0603 | 8,944 | 8,823 | $0.62 |