NPI: 1326760737 · PHOENIX, AZ 85043 · General Practice Dentistry · NPI assigned 09/13/2022
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 09/13/2022 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 7,476 | $86K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 534 | 270 | $16K |
| D1120 | Prophylaxis - child | 770 | 763 | $11K |
| D0150 | Comprehensive oral evaluation - new or established patient | 673 | 667 | $9K |
| D0330 | Panoramic radiographic image | 462 | 458 | $6K |
| D0230 | Intraoral - periapical each additional radiographic image | 1,039 | 624 | $6K |
| D1208 | Topical application of fluoride, excluding varnish | 844 | 837 | $6K |
| D1351 | Sealant - per tooth | 648 | 242 | $5K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 137 | 79 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 772 | 759 | $4K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 96 | 66 | $3K |
| D0274 | Bitewings - four radiographic images | 270 | 268 | $2K |
| D0272 | Bitewings - two radiographic images | 308 | 303 | $2K |
| D1110 | Prophylaxis - adult | 147 | 146 | $2K |
| D1354 | 222 | 63 | $2K | |
| D0140 | Limited oral evaluation - problem focused | 123 | 123 | $2K |
| D0120 | Periodic oral evaluation - established patient | 177 | 176 | $2K |
| D0145 | Oral evaluation for a patient under three years of age | 78 | 78 | $869.62 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 59 | 54 | $574.27 |
| D1206 | Topical application of fluoride varnish | 80 | 80 | $488.92 |
| D1353 | 37 | 17 | $136.45 |