NPI: 1649910944 · TUCSON, AZ 85713 · General Practice Dentistry · NPI assigned 04/01/2022
Authorized official KOUYOUMDJIAN, RAFFY controls 19+ related entities in our dataset. Read more
| Authorized Official | KOUYOUMDJIAN, RAFFY (OWNER) |
| NPI Enumeration Date | 04/01/2022 |
Other providers sharing the same authorized official: KOUYOUMDJIAN, RAFFY
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 264 | $970.47 |
| 2024 | 4,982 | $44K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 670 | 666 | $7K |
| D0150 | Comprehensive oral evaluation - new or established patient | 586 | 582 | $7K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 230 | 75 | $7K |
| D0230 | Intraoral - periapical each additional radiographic image | 808 | 438 | $4K |
| D1208 | Topical application of fluoride, excluding varnish | 750 | 741 | $4K |
| D1354 | 331 | 106 | $3K | |
| D0330 | Panoramic radiographic image | 205 | 202 | $2K |
| D0210 | Intraoral - complete series of radiographic images | 126 | 124 | $2K |
| D0220 | Intraoral - periapical first radiographic image | 480 | 474 | $2K |
| D1351 | Sealant - per tooth | 320 | 94 | $2K |
| D1110 | Prophylaxis - adult | 107 | 103 | $2K |
| D0120 | Periodic oral evaluation - established patient | 198 | 194 | $1K |
| D0272 | Bitewings - two radiographic images | 221 | 217 | $1K |
| D0274 | Bitewings - four radiographic images | 66 | 65 | $397.60 |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 71 | 67 | $397.46 |
| D0145 | Oral evaluation for a patient under three years of age | 41 | 41 | $330.39 |
| D1206 | Topical application of fluoride varnish | 15 | 15 | $160.40 |
| D0350 | 21 | 17 | $22.94 |