Chen, Jack

Chen, Jack was paid $21K by Medicaid between Jan 2018 and Apr 2019, across 8 billing codes. Its largest line is D1110, Prophylaxis - adult — 27% of everything it billed.

33Billing provider infoCHEN, JACK
MONTEREY PARK, CA 91755

33aNPI1194883694assigned 12/05/2006

33bProvider typeDentist

28Total paid$21K

24GClaims1,036

24DCodes billed8

24AFirst – last monthJan 2018 – Apr 2019

Compared with peers

Next to other Dentist providers in California

Rank by total paid#1,755 of 2,314

Median peer was paid$185K

This provider vs. median0.1×

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.

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	759	$13K
2019	277	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D1110	Prophylaxis - adult	27%	79	79	$6K
D0150	Comprehensive oral evaluation - new or established patient	19%	68	68	$4K
D0230	Intraoral - periapical each additional radiographic image	13%	353	191	$3K
D1208	Topical application of fluoride, excluding varnish	13%	256	255	$3K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	10%	55	55	$2K
D0220	Intraoral - periapical first radiographic image	9.6%	182	153	$2K
D0210	Intraoral - complete series of radiographic images	6.6%	31	31	$1K
D1120	Dental cleaning, childProphylaxis - child	1.7%	12	12	$360.00

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.