TENDER DENTAL BONANZA, LLC

NPI: 1679227839 · LAS VEGAS, NV 89110 · General Practice Dentistry · NPI assigned 02/07/2022

$59K

Total Medicaid Paid

2,497

Total Claims

1,556

Beneficiaries

Codes Billed

2022-01

First Month

2022-12

Last Month

Provider Details

Authorized Official	SHERMAN, MICHAEL (CLINICAL DIRECTOR)
NPI Enumeration Date	02/07/2022

Other providers sharing the same authorized official: SHERMAN, MICHAEL

Provider	City	State	Total Paid
MICHAEL S. SHERMAN, DO, PC	GARDEN CITY	MI	$119K
MICHAEL P SHERMAN MD PHD, A MEDICAL CORPORATION	WALNUT CREEK	CA	$101K
AGAPE INTERNAL MEDICINE & PEDIATRICS, P.C.	ALBANY	OR	$32K
ALLERGY & ASTHMA CENTER, P.C.	MARLBORO	NJ	$21K
TENDER DENTAL BOULDER, LLC	LAS VEGAS	NV	$17K
TENDER DENTAL MEAD, LLC	LAS VEGAS	NV	$13K

Year	Claims	Total Paid
2022	2,497	$59K

Code	Description	Claims	Beneficiaries	Total Paid
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth	667	213	$28K
D0140	Limited oral evaluation - problem focused	370	322	$10K
D0220	Intraoral - periapical first radiographic image	525	449	$5K
D1351	Sealant - per tooth	251	26	$4K
D0210	Intraoral - complete series of radiographic images	76	59	$2K
D0120	Periodic oral evaluation - established patient	150	131	$2K
D0150	Comprehensive oral evaluation - new or established patient	82	67	$2K
D0274	Bitewings - four radiographic images	122	100	$2K
D1110	Prophylaxis - adult	93	68	$2K
D1206	Topical application of fluoride varnish	25	17	$525.00
D0230	Intraoral - periapical each additional radiographic image	136	104	$501.54