RAFFI MALKOUNIAN DDS, INC.
NPI: 1235284118
· PASADENA, CA 91104
· Dental Clinic/Center
· NPI assigned 01/24/2007
$246K
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
996 |
$27K |
| 2019 |
822 |
$39K |
| 2020 |
843 |
$35K |
| 2021 |
981 |
$29K |
| 2022 |
1,169 |
$46K |
| 2023 |
883 |
$35K |
| 2024 |
846 |
$34K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,293 |
1,284 |
$70K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
879 |
875 |
$56K |
| D1110 |
Prophylaxis - adult |
568 |
568 |
$49K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,080 |
1,060 |
$16K |
| D5110 |
|
24 |
24 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
1,205 |
1,187 |
$14K |
| D1208 |
Topical application of fluoride, excluding varnish |
984 |
982 |
$13K |
| D0272 |
Bitewings - two radiographic images |
447 |
446 |
$5K |
| D5750 |
|
24 |
24 |
$5K |
| D5751 |
|
12 |
12 |
$2K |
| D9430 |
|
24 |
24 |
$720.00 |