Pancholi, Surabhi

Pancholi, Surabhi was paid $110K by Medicaid between Jul 2020 and Mar 2021, across 17 billing codes. Its largest line is D2392, Resin-based composite - two surfaces, posterior, primary or permanent — 28% of everything it billed.

33Billing provider infoPANCHOLI, SURABHI
SAINT PAUL, MN 55108

33aNPI1992208276assigned 03/13/2018

33bProvider typeDentist

28Total paid$110K

24GClaims3,843

24DCodes billed17

24AFirst – last monthJul 2020 – Mar 2021

Compared with peers

Next to other Dentist providers in Minnesota

Rank by total paid#43 of 192

Median peer was paid$9K

This provider vs. median12×

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
2020	2,481	$70K
2021	1,362	$39K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	28%	625	292	$31K
D2393	Resin-based composite - three surfaces, posterior, primary or permanent	12%	230	145	$14K
D0140	Limited oral evaluation - problem focused	9.9%	380	357	$11K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	9.4%	168	78	$10K
D0330	Panoramic radiographic image	8.8%	287	273	$10K
D2391	Resin-based composite - one surface, posterior, primary or permanent	8.3%	232	129	$9K
D7140	Extraction, erupted tooth or exposed root	6.3%	200	75	$7K
D0150	Comprehensive oral evaluation - new or established patient	4.9%	232	225	$5K
D0274	Bitewings - four radiographic images	4.6%	280	265	$5K
D2335		1.6%	23	14	$2K
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	1.5%	94	88	$2K
D2332		1.0%	18	12	$1K

5 more codes

D0220	Intraoral - periapical first radiographic image	<1%	353	$1K
D1351	Sealant - per tooth	<1%	58	$1K
D0230	Intraoral - periapical each additional radiographic image	<1%	638	$503.83
D1120	Dental cleaning, child	<1%	12	$476.19
D1208	Topical application of fluoride, excluding varnish	<1%	13	$166.05

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.