Dental
Elsa Dental and Orthodontics, PLLC
Elsa Dental and Orthodontics, PLLC was paid $7.40M by Medicaid between Aug 2018 and Dec 2024, across 35 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 14% of everything it billed.
33Billing provider infoELSA DENTAL AND ORTHODONTICS, PLLC
FORT WORTH, TX 76102
FORT WORTH, TX 76102
33aNPI1831632173assigned 11/18/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$7.40M
24GClaims222,122
24DCodes billed35
24AFirst – last monthAug 2018 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#23 of 2,774
Median peer was paid$43K
This provider vs. median174×
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
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
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 14 | $0.00 | |
| 2019 | 162 | $1K | |
| 2020 | 6,166 | $185K | |
| 2021 | 47,500 | $1.48M | |
| 2022 | 53,363 | $1.81M | |
| 2023 | 59,418 | $2.00M | |
| 2024incomplete | 55,499 | $1.92M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 14% | 7,135 | 1,471 | $1.04M |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 9,827 | 4,546 | $948K |
| D0145 | Oral evaluation for a patient under three years of age | 8.9% | 4,785 | 4,700 | $660K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.2% | 18,970 | 18,667 | $531K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 6.9% | 6,863 | 3,691 | $512K |
| D1120 | Dental cleaning, childProphylaxis - child | 6.4% | 13,358 | 13,191 | $477K |
| D1351 | Sealant - per tooth | 5.2% | 14,564 | 4,162 | $383K |
| D1110 | Prophylaxis - adult | 4.7% | 6,596 | 6,483 | $349K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.4% | 32,344 | 19,538 | $326K |
| D7240 | Removal of impacted tooth - completely bony | 4.3% | 1,124 | 365 | $316K |
| D1208 | Topical application of fluoride, excluding varnish | 3.9% | 20,480 | 20,157 | $292K |
| D9248 | 3.2% | 1,991 | 1,963 | $233K |
23 more codes
| D0274 | Bitewings - four radiographic images | 3.1% | 7,452 | $233K |
| D0220 | Intraoral - periapical first radiographic image | 3.0% | 20,838 | $222K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 2.5% | 7,017 | $182K |
| D0272 | Bitewings - two radiographic images | 2.1% | 7,673 | $158K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 1.3% | 959 | $99K |
| D0210 | Intraoral - complete series of radiographic images | 1.3% | 1,500 | $95K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | 1.3% | 1,130 | $93K |
| D0330 | Panoramic radiographic image | <1% | 2,796 | $65K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,636 | $54K |
| D0160 | <1% | 2,987 | $43K | |
| D2934 | <1% | 246 | $35K | |
| D1330 | <1% | 2,163 | $23K | |
| D0140 | Limited oral evaluation - problem focused | <1% | 696 | $11K |
| D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | <1% | 212 | $10K |
| D9222 | <1% | 105 | $7K | |
| D0350 | <1% | 223 | $3K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 43 | $3K |
| D9612 | <1% | 81 | $2K | |
| D2330 | <1% | 22 | $2K | |
| D9310 | <1% | 13 | $174.96 | |
| D7111 | <1% | 15 | $160.58 | |
| D0270 | <1% | 12 | $53.90 | |
| D0603 | <1% | 26,266 | $0.08 |
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 (OWNER)
| Provider | Location | 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 |
| Real Smiles | Fort Worth, TX | $7.68M |
| 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.