Dental
Jetty United PLLC
Jetty United PLLC was paid $12.00M by Medicaid between Jun 2022 and Dec 2024, across 31 billing codes. Its largest line is D2930, Prefabricated stainless steel crown - primary tooth — 19% of everything it billed.
33Billing provider infoJETTY UNITED PLLC
SAN ANTONIO, TX 78231
SAN ANTONIO, TX 78231
33aNPI1225797467assigned 12/15/2021
33bProvider typeGeneral Practice Dentistry
28Total paid$12.00M
24GClaims388,234
24DCodes billed31
24AFirst – last monthJun 2022 – Dec 2024
Compared with peers
Next to other General Practice Dentistry providers in Texas
Rank by total paid#3 of 2,774
Median peer was paid$43K
This provider vs. median281×
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.
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 | |
|---|---|---|---|
| 2022 | 54,985 | $1.70M | |
| 2023 | 184,301 | $5.84M | |
| 2024incomplete | 148,948 | $4.47M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D2930 | Prefabricated stainless steel crown - primary tooth | 19% | 16,473 | 3,596 | $2.26M |
| D0145 | Oral evaluation for a patient under three years of age | 13% | 11,484 | 11,348 | $1.58M |
| D1120 | Dental cleaning, childProphylaxis - child | 10% | 38,325 | 37,667 | $1.26M |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 9.8% | 42,929 | 42,226 | $1.17M |
| D1351 | Sealant - per tooth | 7.3% | 35,642 | 8,522 | $875K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 5.7% | 7,463 | 4,312 | $683K |
| D1208 | Topical application of fluoride, excluding varnish | 5.2% | 46,840 | 46,109 | $629K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 4.3% | 7,076 | 4,181 | $517K |
| D1110 | Prophylaxis - adult | 4.2% | 9,892 | 9,740 | $510K |
| D0272 | Bitewings - two radiographic images | 4.2% | 24,474 | 24,062 | $509K |
| D0274 | Bitewings - four radiographic images | 2.9% | 11,256 | 11,061 | $348K |
| D7140 | Extraction, erupted tooth or exposed root | 1.8% | 4,048 | 1,879 | $217K |
19 more codes
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.8% | 8,427 | $212K |
| D0230 | Intraoral - periapical each additional radiographic image | 1.7% | 21,566 | $208K |
| D0220 | Intraoral - periapical first radiographic image | 1.7% | 18,212 | $199K |
| D9248 | 1.2% | 1,311 | $149K | |
| D0330 | Panoramic radiographic image | 1.2% | 4,952 | $144K |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.1% | 4,172 | $137K |
| D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | <1% | 1,287 | $100K |
| D9420 | <1% | 2,549 | $87K | |
| D2934 | <1% | 487 | $68K | |
| D0210 | Intraoral - complete series of radiographic images | <1% | 887 | $60K |
| D0140 | Limited oral evaluation - problem focused | <1% | 1,765 | $31K |
| D0350 | <1% | 3,539 | $26K | |
| D0170 | <1% | 2,771 | $19K | |
| D1206 | Topical application of fluoride varnish | <1% | 702 | $7K |
| D0603 | 0% | 55,330 | $0.00 | |
| D0600 | 0% | 149 | $0.00 | |
| D0601 | 0% | 3,514 | $0.00 | |
| D0602 | 0% | 396 | $0.00 | |
| D9986 | 0% | 316 | $0.00 |
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 officialKENNEDY, PAUL (DOCTOR/OWNER)
| Provider | Location | Paid |
|---|---|---|
| Saints Incorporated | Wayne, MI | $38.13M |
| Paul a Kennedy, JR., D.D.S., INC | Corpus Christi, TX | $8.29M |
| Saratoga Surgical Center, LLC | Corpus Christi, TX | $1.77M |
| KDC Staples, PLLC | Corpus Christi, TX | $2K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.