Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

REAL SMILES

NPI: 1649447236 · FORT WORTH, TX 76119 · Dentist · NPI assigned 05/13/2008

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more

$7.68M
Total Medicaid Paid
237,911
Total Claims
198,548
Beneficiaries
33
Codes Billed
2018-02
First Month
2024-12
Last Month

Provider Details

Authorized OfficialKOUYOUMDJIAN, RAFFY (CEO)
NPI Enumeration Date05/13/2008

Related Entities

Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY

ProviderCityStateTotal Paid
RODEO WESLACO DENTAL & ORTHODONTICS WESLACO TX $14.00M
RODEO DENTAL PHARR PLLC PHARR TX $10.70M
RODEO DENTAL SAN BENITO, PLLC SAN BENITO TX $10.54M
PASADENA DENTAL & ORTHODONTICS PLLC SOUTH HOUSTON TX $8.93M
RODEO DENTAL SOUTHMOST PLLC BROWNSVILLE TX $8.91M
FM KATY DENTAL AND ORTHODONTICS, PLLC FORT WORTH TX $8.87M
ELSA DENTAL AND ORTHODONTICS, PLLC FORT WORTH TX $7.40M
RODEO LAREDO DENTAL & ORTHODONTICS, PLLC LAREDO TX $6.12M
RODEO DENTAL CENTRAL PLLC BROWNSVILLE TX $6.08M
RUBEN TORRES DENTAL, PLLC BROWNSVILLE TX $5.21M
WACO DENTAL AND ORTHODONTICS, PLLC WACO TX $2.19M
CYPRESS POINT DENTAL AND ORTHODONTICS, PLLC HOUSTON TX $1.48M
KIRKWOOD DENTAL AND ORTHODONTICS, PLLC STAFFORD TX $1.18M
PEORIA ST. DENTAL AND ORTHODONTICS PLLC AURORA CO $949K
MIDLAND DENTAL AND ORTHODONTICS, PLLC MIDLAND TX $463K
CASA GRANDE DENTAL AND ORTHODONTICS LLC CASA GRANDE AZ $199K
PHOENIX DENTAL AND ORTHODONTICS, PLLC PHOENIX AZ $86K
TUCSON DENTAL AND ORTHODONTICS TUCSON AZ $45K
290 CROSSING DENTAL AND ORTHODONTICS PLLC HOUSTON TX $16K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 163 $2K
2019 186 $2K
2020 6,189 $226K
2021 52,900 $1.74M
2022 57,247 $1.84M
2023 64,201 $2.15M
2024 57,025 $1.73M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 13,093 5,819 $1.26M
D2930 Prefabricated stainless steel crown - primary tooth 6,214 1,170 $887K
D2391 Resin-based composite - one surface, posterior, primary or permanent 10,227 4,621 $763K
D0145 Oral evaluation for a patient under three years of age 4,895 4,870 $681K
D0120 Periodic oral evaluation - established patient 19,996 19,826 $553K
D1120 Prophylaxis - child 14,152 14,010 $495K
D1351 Sealant - per tooth 18,225 5,323 $458K
D1110 Prophylaxis - adult 7,573 7,495 $392K
D1208 Topical application of fluoride, excluding varnish 22,639 22,406 $317K
D0230 Intraoral - periapical each additional radiographic image 26,816 22,307 $278K
D0220 Intraoral - periapical first radiographic image 24,306 23,961 $276K
D0274 Bitewings - four radiographic images 8,136 8,060 $259K
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 8,517 8,164 $223K
D0272 Bitewings - two radiographic images 10,103 10,017 $221K
D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction 1,649 570 $133K
D9248 910 895 $102K
D0150 Comprehensive oral evaluation - new or established patient 2,460 2,414 $82K
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment 896 394 $45K
D2393 Resin-based composite - three surfaces, posterior, primary or permanent 384 249 $38K
D0210 Intraoral - complete series of radiographic images 483 477 $32K
D9222 403 396 $29K
D7140 Extraction, erupted tooth or exposed root 461 230 $28K
D0140 Limited oral evaluation - problem focused 1,557 1,532 $27K
D0160 1,693 1,648 $24K
D0330 Panoramic radiographic image 1,023 1,012 $24K
D2934 144 43 $20K
D1330 1,654 1,613 $18K
D9612 287 282 $8K
D2330 50 26 $4K
D2950 32 26 $1K
D3910 32 25 $143.36
D0270 16 16 $73.50
D0603 28,885 28,651 $0.02