NPI: 1356008858 · STAFFORD, TX 77477 · General Practice Dentistry · NPI assigned 11/19/2021
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 11/19/2021 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 5,115 | $145K |
| 2023 | 16,965 | $556K |
| 2024 | 16,708 | $476K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 1,882 | 634 | $174K |
| D2930 | Prefabricated stainless steel crown - primary tooth | 1,244 | 241 | $173K |
| D0145 | Oral evaluation for a patient under three years of age | 1,087 | 1,080 | $143K |
| D1351 | Sealant - per tooth | 4,281 | 1,030 | $103K |
| D1120 | Prophylaxis - child | 2,403 | 2,364 | $80K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1,840 | 1,796 | $56K |
| D0230 | Intraoral - periapical each additional radiographic image | 6,309 | 3,066 | $56K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 753 | 383 | $55K |
| D0120 | Periodic oral evaluation - established patient | 1,658 | 1,629 | $45K |
| D1208 | Topical application of fluoride, excluding varnish | 3,409 | 3,349 | $45K |
| D1110 | Prophylaxis - adult | 886 | 870 | $43K |
| D9248 | 302 | 297 | $34K | |
| D0274 | Bitewings - four radiographic images | 1,177 | 1,154 | $33K |
| D0220 | Intraoral - periapical first radiographic image | 3,270 | 3,201 | $31K |
| D0330 | Panoramic radiographic image | 708 | 685 | $24K |
| D0210 | Intraoral - complete series of radiographic images | 313 | 312 | $20K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 196 | 89 | $17K |
| D0272 | Bitewings - two radiographic images | 850 | 830 | $14K |
| D0160 | 511 | 496 | $7K | |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 83 | 24 | $7K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 277 | 256 | $7K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 71 | 31 | $4K |
| D1330 | 317 | 306 | $3K | |
| D9222 | 31 | 31 | $2K | |
| D9612 | 33 | 30 | $890.25 | |
| D0140 | Limited oral evaluation - problem focused | 47 | 44 | $807.98 |
| D0350 | 27 | 27 | $257.32 | |
| D0603 | 4,823 | 4,753 | $0.32 |