Dental
SD- 4315Frederick PC
SD- 4315Frederick PC was paid $218K by Medicaid between Jan 2021 and Nov 2024, across 16 billing codes. Its largest line is D1110, Prophylaxis - adult — 16% of everything it billed.
33Billing provider infoSD- 4315FREDERICK PC
SAN ANTONIO, TX 78201
SAN ANTONIO, TX 78201
33aNPI1174074496assigned 10/21/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$218K
24GClaims11,989
24DCodes billed16
24AFirst – last monthJan 2021 – Nov 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#798 of 2,774
Median peer was paid$43K
This provider vs. median5.1×
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 PHAM, LYNHTHY controls 20+ 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 | |
|---|---|---|---|
| 2021 | 1,722 | $26K | |
| 2022 | 4,866 | $89K | |
| 2023 | 3,836 | $75K | |
| 2024incomplete | 1,565 | $27K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 16% | 682 | 673 | $35K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 13% | 1,072 | 1,053 | $29K |
| D0274 | Bitewings - four radiographic images | 12% | 943 | 927 | $26K |
| D1208 | Topical application of fluoride, excluding varnish | 9.8% | 1,514 | 1,489 | $21K |
| D1351 | Sealant - per tooth | 9.1% | 840 | 141 | $20K |
| D0230 | Intraoral - periapical each additional radiographic image | 9.1% | 2,234 | 1,719 | $20K |
| D0220 | Intraoral - periapical first radiographic image | 8.8% | 1,849 | 1,804 | $19K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.5% | 533 | 523 | $19K |
| D0150 | Comprehensive oral evaluation - new or established patient | 6.2% | 408 | 395 | $13K |
| D0145 | Oral evaluation for a patient under three years of age | 2.7% | 41 | 41 | $6K |
| D0330 | Panoramic radiographic image | 2.2% | 216 | 206 | $5K |
| D0210 | Intraoral - complete series of radiographic images | 1.1% | 41 | 41 | $2K |
4 more codes
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 officialPHAM, LYNHTHY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| SD Greenville LLC | Greenville, TX | $719K |
| SD Corpus Christi PLLC | Corpus Christi, TX | $557K |
| SD- Roosevelt PC | San Antonio, TX | $314K |
| SD Texarkana | Texarkana, TX | $280K |
| Smiley Dental Singleton PLLC | Dallas, TX | $215K |
| SD- Potranco, PC | San Antonio, TX | $178K |
| Smiley Dental - University | Denton, TX | $114K |
| Smiley Dental Mccart PLLC | Fort Worth, TX | $55K |
| Smiley Dental Kemp PLLC | Wichita Falls, TX | $47K |
| SD Meadowbrook PLLC | Fort Worth, TX | $26K |
| Sd-Braun, PC | San Antonio, TX | $22K |
| Sd-933Schertz PC | Schertz, TX | $22K |
| Sd-Hwy 78 PC | San Antonio, TX | $20K |
| Sd-Dezavala PC | San Antonio, TX | $15K |
| Smiley Dental Lamar PLLC | Austin, TX | $12K |
| SD Saginaw PLLC | Saginaw, TX | $8K |
| SD Park Row PLLC | Arlington, TX | $6K |
| SD Haltom City PLLC | Haltom City, TX | $4K |
| SD Valley Mills PLLC | Waco, TX | $3K |
| SD Park Lake PLLC | Waco, TX | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.