Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Rhode Island for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Rhode Island only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Rhode Island (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Miguel Roca (NPI 1104111962)

Field	Value
Entity Type	Individual
Organization	Miguel Roca
Address	700 School St # Condo1
City	Pawtucket
State	RI
ZIP	02860
Taxonomy	General Practice Dentistry
NPI Enumerated	June 9, 2011

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	6,190	$40	$229K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	6,440	$30	$218.8K
D0330	N/A	4,020	$50	$205.2K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	1,860	$100	$187.9K
D1120	Prophylaxis–child	4,130	$40	$173.5K
D0140	Limited oral evaluation – problem focused	4,890	$30	$137K
D0120	Periodic oral evaluation - established patient	6,130	$20	$110.3K
D0274	N/A	4,410	$20	$101.4K
D1351	Sealant - per tooth	4,250	$20	$85K
D2392	Post 2 surface resin‑based composite	880	$70	$64.2K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

Claims Volume vs. Rhode Island Distribution

Miguel Roca — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	8	30	350	$110	$158.2K
D1120	Prophylaxis–child	31	160	710	$30	$91.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	20	150	800	$30	$81.3K
D9920	N/A	8	20	150	$50	$71.9K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	35	100	510	$50	$65.4K
D2392	Post 2 surface resin‑based composite	31	110	240	$60	$47.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	15	180	490	$20	$42.3K
D1351	Sealant - per tooth	16	90	670	$20	$41.4K
D0120	Periodic oral evaluation - established patient	20	210	930	$10	$38.1K
D1208	Topical application of fluoride - excluding varnish	17	100	290	$20	$32.1K

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with Miguel Roca, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Miguel Roca Inc	RI	Dentist	$0	$883.6K

Nearby Providers

Other providers in the same ZIP code as Miguel Roca, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gateway Healthcare Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$122.7M
Nursing Placement, Inc.	RI	Home Health Agency	$0	$63.4M
United Cerebral Palsy Of Rhode Island, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$21.3M
Lifetime Financial Management Inc.	RI	Home Health Agency	$0	$20.9M
Addiction Recovery Institute	RI	Community/Behavioral Health Agency	$180.1K	$15.4M
Blackstone Valley Community Health Care	RI	Federally Qualified Health Center (FQHC)	$0	$14.2M
Blackstone Valley Community Health Care, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$12.4M
United Cerebral Palsy Of Rhode Island, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$9.6M
Dr. Day Care, Inc.	RI	Counselor	$0	$8.7M
Sheila Brijade	RI	Pediatric Dentistry	$0	$7.7M

Miguel Roca — Billing Profile & Reimbursement Data

Sign up for Miguel Roca — Billing Profile & Reimbursement Data policy alerts

Miguel Roca — Billing Profile & Reimbursement Data

Sign up for Miguel Roca — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References