Medicaid Provider Spending

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

SD- ROOSEVELT PC

NPI: 1366993529 · SAN ANTONIO, TX 78214 · General Practice Dentistry · NPI assigned 10/21/2016

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

Authorized official PHAM, LYNHTHY controls 20+ related entities in our dataset. Read more

$314K
Total Medicaid Paid
15,633
Total Claims
13,189
Beneficiaries
16
Codes Billed
2020-11
First Month
2024-10
Last Month

Provider Details

Authorized OfficialPHAM, LYNHTHY (PRESIDENT)
NPI Enumeration Date10/21/2016

Related Entities

Other providers sharing the same authorized official: PHAM, LYNHTHY

ProviderCityStateTotal Paid
SD GREENVILLE LLC GREENVILLE TX $719K
SD CORPUS CHRISTI PLLC CORPUS CHRISTI TX $557K
SD TEXARKANA TEXARKANA TX $280K
SD- 4315FREDERICK PC SAN ANTONIO TX $218K
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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 710 $14K
2021 5,481 $106K
2022 4,933 $107K
2023 3,315 $69K
2024 1,194 $19K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1110 Prophylaxis - adult 930 916 $48K
D0120 Periodic oral evaluation - established patient 1,581 1,555 $43K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 467 158 $40K
D1351 Sealant - per tooth 1,354 232 $32K
D0274 Bitewings - four radiographic images 1,098 1,068 $31K
D1208 Topical application of fluoride, excluding varnish 1,847 1,815 $26K
D1120 Prophylaxis - child 730 716 $25K
D0230 Intraoral - periapical each additional radiographic image 2,615 1,857 $25K
D0220 Intraoral - periapical first radiographic image 2,078 2,011 $22K
D0150 Comprehensive oral evaluation - new or established patient 286 274 $9K
D0330 Panoramic radiographic image 230 225 $6K
D0272 Bitewings - two radiographic images 276 270 $5K
D2391 Resin-based composite - one surface, posterior, primary or permanent 30 16 $2K
D0603 1,573 1,542 $0.00
D0601 347 343 $0.00
D0602 191 191 $0.00