NPI: 1528350782 · SAN BENITO, TX 78586 · Endodontist · NPI assigned 05/06/2011
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 05/06/2011 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 272 | $2K |
| 2019 | 659 | $14K |
| 2020 | 10,288 | $328K |
| 2021 | 78,550 | $2.47M |
| 2022 | 83,327 | $2.54M |
| 2023 | 90,913 | $3.04M |
| 2024 | 70,490 | $2.15M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 14,404 | 6,505 | $1.34M |
| D2930 | Prefabricated stainless steel crown - primary tooth | 8,198 | 2,120 | $1.17M |
| D0145 | Oral evaluation for a patient under three years of age | 6,725 | 6,695 | $936K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 13,057 | 6,032 | $919K |
| D0120 | Periodic oral evaluation - established patient | 29,324 | 29,003 | $818K |
| D1351 | Sealant - per tooth | 30,820 | 8,960 | $794K |
| D1120 | Prophylaxis - child | 18,606 | 18,368 | $658K |
| D1110 | Prophylaxis - adult | 10,654 | 10,544 | $557K |
| D0230 | Intraoral - periapical each additional radiographic image | 48,866 | 29,780 | $491K |
| D1208 | Topical application of fluoride, excluding varnish | 30,001 | 29,639 | $423K |
| D0274 | Bitewings - four radiographic images | 13,538 | 13,393 | $406K |
| D0220 | Intraoral - periapical first radiographic image | 31,538 | 31,065 | $339K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 10,293 | 9,974 | $265K |
| D2934 | 1,568 | 527 | $215K | |
| D0272 | Bitewings - two radiographic images | 10,101 | 10,012 | $208K |
| D7240 | Removal of impacted tooth - completely bony | 694 | 223 | $188K |
| D9248 | 1,582 | 1,560 | $183K | |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1,279 | 773 | $122K |
| D0210 | Intraoral - complete series of radiographic images | 1,640 | 1,616 | $97K |
| D0330 | Panoramic radiographic image | 3,516 | 3,479 | $97K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1,086 | 379 | $88K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | 840 | 446 | $44K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1,357 | 1,337 | $44K |
| D0160 | 2,855 | 2,794 | $41K | |
| D9222 | 451 | 446 | $33K | |
| D0140 | Limited oral evaluation - problem focused | 1,308 | 1,268 | $23K |
| D7140 | Extraction, erupted tooth or exposed root | 141 | 94 | $8K |
| D7111 | 663 | 433 | $7K | |
| D2330 | 117 | 61 | $7K | |
| D9612 | 221 | 202 | $6K | |
| D1330 | 161 | 159 | $2K | |
| D0270 | 133 | 133 | $575.26 | |
| D0603 | 38,762 | 38,475 | $0.05 |