NPI: 1265839344 · FORT WORTH, TX 76102 · Dentist · NPI assigned 12/04/2014
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 12/04/2014 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 135 | $573.30 |
| 2019 | 113 | $886.21 |
| 2020 | 7,017 | $217K |
| 2021 | 59,847 | $1.97M |
| 2022 | 72,310 | $2.35M |
| 2023 | 70,616 | $2.31M |
| 2024 | 62,370 | $2.01M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14,788 | 6,287 | $1.40M |
| D2930 | Prefabricated stainless steel crown - primary tooth | 9,205 | 1,694 | $1.27M |
| D1351 | Sealant - per tooth | 25,339 | 6,590 | $648K |
| D0120 | Periodic oral evaluation - established patient | 21,632 | 21,327 | $591K |
| D1120 | Prophylaxis - child | 16,196 | 15,968 | $557K |
| D0145 | Oral evaluation for a patient under three years of age | 3,751 | 3,696 | $514K |
| D1110 | Prophylaxis - adult | 8,052 | 7,906 | $408K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 5,598 | 3,074 | $406K |
| D0230 | Intraoral - periapical each additional radiographic image | 36,358 | 23,431 | $359K |
| D0274 | Bitewings - four radiographic images | 11,711 | 11,507 | $355K |
| D1208 | Topical application of fluoride, excluding varnish | 24,571 | 24,179 | $339K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 3,857 | 1,080 | $302K |
| D0220 | Intraoral - periapical first radiographic image | 25,364 | 24,868 | $269K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 7,864 | 7,345 | $200K |
| D9248 | 1,813 | 1,765 | $197K | |
| D2934 | 1,180 | 321 | $165K | |
| D0272 | Bitewings - two radiographic images | 7,568 | 7,461 | $154K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1,582 | 967 | $147K |
| D0150 | Comprehensive oral evaluation - new or established patient | 3,311 | 3,196 | $106K |
| D0210 | Intraoral - complete series of radiographic images | 1,514 | 1,492 | $99K |
| D0330 | Panoramic radiographic image | 2,724 | 2,676 | $83K |
| D7240 | Removal of impacted tooth - completely bony | 309 | 92 | $81K |
| D7140 | Extraction, erupted tooth or exposed root | 874 | 467 | $48K |
| D0160 | 3,271 | 3,124 | $46K | |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 719 | 285 | $36K |
| D9222 | 292 | 286 | $21K | |
| D0140 | Limited oral evaluation - problem focused | 1,077 | 1,055 | $19K |
| D3330 | Endodontic therapy, molar tooth (excluding final restoration) | 30 | 24 | $17K |
| D1330 | 1,560 | 1,524 | $16K | |
| D9612 | 282 | 260 | $8K | |
| D0367 | 14 | 13 | $2K | |
| D7111 | 52 | 38 | $562.03 | |
| D0270 | 111 | 109 | $494.90 | |
| D2940 | 21 | 15 | $244.65 | |
| D3910 | 19 | 14 | $89.60 | |
| D0603 | 29,799 | 29,423 | $0.24 |