Clinic
DR Jack Pai DDS INC
DR Jack Pai DDS INC was paid $34K by Medicaid between Apr 2022 and Dec 2024, across 8 billing codes. Its largest line is D9430, — 34% of everything it billed.
33Billing provider infoDR JACK PAI DDS INC
TUSTIN, CA 92780
TUSTIN, CA 92780
33aNPI1295310522assigned 03/17/2021
33bProvider typeDental Clinic/Center
28Total paid$34K
24GClaims1,523
24DCodes billed8
24AFirst – last monthApr 2022 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in California
Rank by total paid#834 of 1,135
Median peer was paid$200K
This provider vs. median0.2×
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 | 137 | $9K | |
| 2024incomplete | 1,386 | $25K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9430 | 34% | 363 | 285 | $12K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 26% | 134 | 134 | $9K |
| D0350 | 20% | 702 | 144 | $7K | |
| D0210 | Intraoral - complete series of radiographic images | 8.1% | 57 | 57 | $3K |
| D1110 | Prophylaxis - adult | 7.2% | 28 | 28 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 2.2% | 181 | 57 | $733.05 |
| D1206 | Topical application of fluoride varnish | 1.6% | 34 | 34 | $531.50 |
| D0274 | Bitewings - four radiographic images | 1.1% | 24 | 24 | $388.80 |
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 officialPAI, JACK (OWNER)