NPI: 1225750128 · MIDLAND, TX 79706 · General Practice Dentistry · NPI assigned 09/16/2022
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 09/16/2022 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 6,033 | $136K |
| 2024 | 12,196 | $328K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 491 | 88 | $66K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 691 | 278 | $62K |
| D0145 | Oral evaluation for a patient under three years of age | 441 | 429 | $57K |
| D1351 | Sealant - per tooth | 1,884 | 334 | $42K |
| D1120 | Prophylaxis - child | 1,228 | 1,177 | $38K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1,033 | 977 | $31K |
| D0230 | Intraoral - periapical each additional radiographic image | 3,303 | 1,516 | $30K |
| D1208 | Topical application of fluoride, excluding varnish | 1,778 | 1,693 | $22K |
| D0120 | Periodic oral evaluation - established patient | 726 | 688 | $19K |
| D0220 | Intraoral - periapical first radiographic image | 1,746 | 1,656 | $16K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 244 | 94 | $15K |
| D1110 | Prophylaxis - adult | 284 | 272 | $13K |
| D0210 | Intraoral - complete series of radiographic images | 197 | 189 | $11K |
| D0274 | Bitewings - four radiographic images | 284 | 265 | $8K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 144 | 54 | $8K |
| D0272 | Bitewings - two radiographic images | 431 | 411 | $7K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 80 | 28 | $6K |
| D9222 | 54 | 54 | $4K | |
| D0160 | 180 | 165 | $2K | |
| D0330 | Panoramic radiographic image | 131 | 126 | $2K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 19 | 12 | $2K |
| D9612 | 42 | 42 | $1K | |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 52 | 46 | $1K |
| D1330 | 106 | 100 | $981.53 | |
| D9248 | 14 | 12 | $853.16 | |
| D0603 | 2,646 | 2,561 | $0.00 |