Dental
Sambath Keo, DMD, INC
Sambath Keo, DMD, INC was paid $109K by Medicaid between Jan 2018 and Mar 2020, across 12 billing codes. Its largest line is D1110, Prophylaxis - adult — 35% of everything it billed.
33Billing provider infoSAMBATH KEO, DMD, INC
LOWELL, MA 01851
LOWELL, MA 01851
33aNPI1366614174assigned 04/01/2008
33bProvider typeGeneral Practice Dentistry
28Total paid$109K
24GClaims3,781
24DCodes billed12
24AFirst – last monthJan 2018 – Mar 2020
Compared with peers
Next to other General Practice Dentistry providers in Massachusetts
Rank by total paid#325 of 693
Median peer was paid$87K
This provider vs. median1.3×
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 | 2,095 | $61K | |
| 2019 | 1,379 | $40K | |
| 2020 | 307 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 35% | 723 | 721 | $38K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 16% | 755 | 753 | $18K |
| D0220 | Intraoral - periapical first radiographic image | 11% | 748 | 730 | $12K |
| D0272 | Bitewings - two radiographic images | 10% | 448 | 446 | $11K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.7% | 549 | 501 | $7K |
| D0140 | Limited oral evaluation - problem focused | 5.2% | 145 | 141 | $6K |
| D1208 | Topical application of fluoride, excluding varnish | 4.8% | 182 | 181 | $5K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 3.3% | 59 | 26 | $4K |
| D9110 | 3.3% | 89 | 89 | $4K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 2.7% | 43 | 24 | $3K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 28 | 28 | $1K |
| D1120 | Dental cleaning, childProphylaxis - child | <1% | 12 | 12 | $612.00 |
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 officialKEO, SAMBATH (PRESIDENT)