Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Dental

Real Smiles

Real Smiles was paid $7.68M by Medicaid between Feb 2018 and Dec 2024, across 33 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 16% of everything it billed.

33Billing provider infoREAL SMILES
FORT WORTH, TX 76119
33aNPI1649447236assigned 05/13/2008
33bProvider typeDentist
28Total paid$7.68M
24GClaims237,911
24DCodes billed33
24AFirst – last monthFeb 2018 – Dec 2024
Compared with peers

Next to other Dentist providers in Texas

Rank by total paid#18 of 1,678
Median peer was paid$35K
This provider vs. median223×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$100K$200K$300K2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
2018163$2K
2019186$2K
20206,189$226K
202152,900$1.74M
202257,247$1.84M
202364,201$2.15M
2024incomplete57,025$1.73M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 16% 13,093 5,819 $1.26M
D2930 Prefabricated stainless steel crown - primary tooth 12% 6,214 1,170 $887K
D2391 Resin-based composite - one surface, posterior, primary or permanent 9.9% 10,227 4,621 $763K
D0145 Oral evaluation for a patient under three years of age 8.9% 4,895 4,870 $681K
D0120 Dental checkup, returning patientPeriodic oral evaluation - established patient 7.2% 19,996 19,826 $553K
D1120 Dental cleaning, childProphylaxis - child 6.4% 14,152 14,010 $495K
D1351 Sealant - per tooth 6.0% 18,225 5,323 $458K
D1110 Prophylaxis - adult 5.1% 7,573 7,495 $392K
D1208 Topical application of fluoride, excluding varnish 4.1% 22,639 22,406 $317K
D0230 Intraoral - periapical each additional radiographic image 3.6% 26,816 22,307 $278K
D0220 Intraoral - periapical first radiographic image 3.6% 24,306 23,961 $276K
D0274 Bitewings - four radiographic images 3.4% 8,136 8,060 $259K
21 more codes
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 2.9% 8,517 $223K
D0272 Bitewings - two radiographic images 2.9% 10,103 $221K
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 1.7% 1,649 $133K
D9248 1.3% 910 $102K
D0150 Comprehensive oral evaluation - new or established patient 1.1% 2,460 $82K
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment <1% 896 $45K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent <1% 384 $38K
D0210 Intraoral - complete series of radiographic images <1% 483 $32K
D9222 <1% 403 $29K
D7140 Extraction, erupted tooth or exposed root <1% 461 $28K
D0140 Limited oral evaluation - problem focused <1% 1,557 $27K
D0160 <1% 1,693 $24K
D0330 Panoramic radiographic image <1% 1,023 $24K
D2934 <1% 144 $20K
D1330 <1% 1,654 $18K
D9612 <1% 287 $8K
D2330 <1% 50 $4K
D2950 <1% 32 $1K
D3910 <1% 32 $143.36
D0270 <1% 16 $73.50
D0603 <1% 28,885 $0.02

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialKOUYOUMDJIAN, RAFFY (CEO)
Same official

Other billing entities under KOUYOUMDJIAN, RAFFY

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.