BRUCE T. ROACH, D.D.S., P.C.
NPI: 1427459049
· WATERFORD, MI 48327
· General Practice Dentistry
· NPI assigned 09/15/2014
$930.00
Total Medicaid Paid
Provider Details
| Authorized Official | ARNOLD, LORI (OFFICE COORDINATOR) |
| NPI Enumeration Date | 09/15/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
41 |
$930.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
12 |
12 |
$369.00 |
| D0120 |
Periodic oral evaluation - established patient |
16 |
16 |
$336.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
13 |
$225.00 |