Physician
Carlos A. Cruz, MD, PC
Carlos A. Cruz, MD, PC was paid $5.63M by Medicaid between Jan 2018 and Dec 2024, across 64 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 32% of everything it billed.
33Billing provider infoCARLOS A. CRUZ, MD, PC
ALEXANDRIA, VA 22302
ALEXANDRIA, VA 22302
33aNPI1205221942assigned 03/31/2015
33bProvider typePediatrics Physician
28Total paid$5.63M
24GClaims130,828
24DCodes billed64
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#23 of 817
Median peer was paid$29K
This provider vs. median192×
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 | 1,583 | $63K | |
| 2019 | 1,443 | $59K | |
| 2020 | 25,409 | $1.02M | |
| 2021 | 25,705 | $1.05M | |
| 2022 | 27,309 | $1.15M | |
| 2023 | 25,841 | $1.19M | |
| 2024incomplete | 23,538 | $1.10M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 21,529 | 19,289 | $1.81M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 12% | 5,899 | 5,585 | $699K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.8% | 5,252 | 5,150 | $551K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.7% | 4,656 | 4,533 | $487K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 7.7% | 3,785 | 3,731 | $434K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.2% | 3,012 | 2,823 | $293K |
| 92552 | 4.5% | 9,906 | 9,699 | $251K | |
| 90686 | 2.2% | 5,686 | 5,573 | $122K | |
| D1206 | Topical application of fluoride varnish | 1.6% | 3,502 | 3,481 | $88K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.4% | 5,002 | 4,856 | $80K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 2,472 | 2,438 | $55K |
| 90670 | <1% | 2,173 | 2,098 | $49K |
52 more codes
| 96127 | <1% | 4,942 | $44K | |
| 90651 | <1% | 1,798 | $44K | |
| 99177 | <1% | 8,435 | $42K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,733 | $39K |
| 90680 | <1% | 1,712 | $37K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,797 | $37K |
| 90633 | <1% | 1,591 | $34K | |
| 90734 | <1% | 1,451 | $34K | |
| 90647 | <1% | 1,582 | $32K | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | <1% | 3,546 | $31K |
| 90620 | <1% | 1,016 | $28K | |
| 90723 | <1% | 1,190 | $26K | |
| 90677 | <1% | 412 | $23K | |
| 2015F | <1% | 1,099 | $20K | |
| 90710 | <1% | 735 | $18K | |
| 90697 | <1% | 489 | $18K | |
| 90700 | <1% | 775 | $16K | |
| 92551 | <1% | 1,606 | $15K | |
| W7000 | <1% | 2,687 | $14K | |
| 90715 | <1% | 612 | $14K | |
| 90696 | <1% | 589 | $13K | |
| 97802 | <1% | 505 | $12K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 285 | $11K |
| 90716 | <1% | 509 | $11K | |
| 90656 | <1% | 463 | $10K | |
| 90707 | <1% | 503 | $10K | |
| 99173 | <1% | 3,717 | $9K | |
| 94760 | <1% | 4,299 | $9K | |
| 86580 | <1% | 1,008 | $7K | |
| 0001A | <1% | 156 | $6K | |
| 99381 | <1% | 59 | $6K | |
| 0002A | <1% | 130 | $5K | |
| 96160 | <1% | 1,934 | $5K | |
| 90661 | <1% | 158 | $5K | |
| 96161 | <1% | 1,693 | $4K | |
| 3008F | <1% | 795 | $3K | |
| 99050 | <1% | 170 | $2K | |
| 90672 | <1% | 86 | $2K | |
| 90688 | <1% | 139 | $2K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 72 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 26 | $1K |
| 99058 | <1% | 57 | $632.85 | |
| 3011F | <1% | 63 | $620.00 | |
| 90713 | <1% | 28 | $588.13 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 76 | $586.34 |
| 99051 | <1% | 47 | $340.00 | |
| 90744 | <1% | 12 | $281.47 | |
| 90687 | <1% | 16 | $174.41 | |
| 81002 | <1% | 58 | $156.29 | |
| 99000 | <1% | 65 | $69.93 | |
| 1005F | 0% | 15 | $0.00 |
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 officialCRUZ, CARLOS (PHYSICIAN)
| Provider | Location | Paid |
|---|---|---|
| Multi Business Solutions | San Juan, PR | $82K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.