Dental
SD- Roosevelt PC
SD- Roosevelt PC was paid $314K by Medicaid between Nov 2020 and Oct 2024, across 16 billing codes. Its largest line is D1110, Prophylaxis - adult — 15% of everything it billed.
33Billing provider infoSD- ROOSEVELT PC
SAN ANTONIO, TX 78214
SAN ANTONIO, TX 78214
33aNPI1366993529assigned 10/21/2016
33bProvider typeGeneral Practice Dentistry
28Total paid$314K
24GClaims15,633
24DCodes billed16
24AFirst – last monthNov 2020 – Oct 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#677 of 2,774
Median peer was paid$43K
This provider vs. median7.4×
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 | |
|---|---|---|---|
| 2020 | 710 | $14K | |
| 2021 | 5,481 | $106K | |
| 2022 | 4,933 | $107K | |
| 2023 | 3,315 | $69K | |
| 2024incomplete | 1,194 | $19K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 15% | 930 | 916 | $48K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 14% | 1,581 | 1,555 | $43K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 467 | 158 | $40K |
| D1351 | Sealant - per tooth | 10% | 1,354 | 232 | $32K |
| D0274 | Bitewings - four radiographic images | 10.0% | 1,098 | 1,068 | $31K |
| D1208 | Topical application of fluoride, excluding varnish | 8.1% | 1,847 | 1,815 | $26K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.0% | 730 | 716 | $25K |
| D0230 | Intraoral - periapical each additional radiographic image | 8.0% | 2,615 | 1,857 | $25K |
| D0220 | Intraoral - periapical first radiographic image | 7.0% | 2,078 | 2,011 | $22K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.9% | 286 | 274 | $9K |
| D0330 | Panoramic radiographic image | 1.8% | 230 | 225 | $6K |
| D0272 | Bitewings - two radiographic images | 1.7% | 276 | 270 | $5K |
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 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.