Dental
Casa Grande Dental and Orthodontics LLC
Casa Grande Dental and Orthodontics LLC was paid $199K by Medicaid between May 2023 and Dec 2024, across 26 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 18% of everything it billed.
33Billing provider infoCASA GRANDE DENTAL AND ORTHODONTICS LLC
CASA GRANDE, AZ 85122
CASA GRANDE, AZ 85122
33aNPI1144970609assigned 03/28/2022
33bProvider typeGeneral Practice Dentistry
28Total paid$199K
24GClaims16,219
24DCodes billed26
24AFirst – last monthMay 2023 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Arizona
Rank by total paid#59 of 530
Median peer was paid$920.17
This provider vs. median217×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 5,890 | $54K | |
| 2024incomplete | 10,329 | $146K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 18% | 977 | 327 | $35K |
| D1120 | Dental cleaning, childProphylaxis - child | 14% | 1,760 | 1,739 | $28K |
| D0150 | Comprehensive oral evaluation - new or established patient | 12% | 1,360 | 1,343 | $24K |
| D0230 | Intraoral - periapical each additional radiographic image | 8.3% | 2,516 | 1,665 | $16K |
| D0330 | Panoramic radiographic image | 8.0% | 698 | 685 | $16K |
| D1208 | Topical application of fluoride, excluding varnish | 6.9% | 1,845 | 1,821 | $14K |
| D1351 | Sealant - per tooth | 6.8% | 1,400 | 396 | $14K |
| D0220 | Intraoral - periapical first radiographic image | 5.2% | 1,816 | 1,779 | $10K |
| D1110 | Prophylaxis - adult | 3.4% | 363 | 355 | $7K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 3.3% | 656 | 644 | $7K |
| D0274 | Bitewings - four radiographic images | 3.1% | 530 | 526 | $6K |
| D0272 | Bitewings - two radiographic images | 2.8% | 638 | 624 | $6K |
14 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.8% | 413 | $4K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.5% | 127 | $3K |
| D0145 | Oral evaluation for a patient under three years of age | 1.1% | 196 | $2K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 48 | $1K |
| D2930 | Prefabricated stainless steel crown - primary tooth | <1% | 105 | $1K |
| D1206 | Topical application of fluoride varnish | <1% | 186 | $1K |
| D0350 | <1% | 279 | $1K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 79 | $988.50 |
| D0340 | <1% | 64 | $710.47 | |
| D0140 | Limited oral evaluation - problem focused | <1% | 39 | $514.82 |
| D9222 | <1% | 29 | $272.98 | |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | <1% | 34 | $272.98 |
| D0160 | <1% | 32 | $149.57 | |
| D9612 | <1% | 29 | $120.52 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialKOUYOUMDJIAN, RAFFY (OWNER)
| Provider | Location | 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 |
| Rodeo Dental Southmost PLLC | Brownsville, TX | $8.91M |
| 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 |
| Phoenix Dental and Orthodontics, PLLC | Phoenix, AZ | $86K |
| Tucson Dental and Orthodontics | Tucson, AZ | $45K |
| 290 Crossing Dental and Orthodontics PLLC | Houston, TX | $16K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.