Physician
Cruz, Carlos
Cruz, Carlos was paid $1.48M by Medicaid between Jan 2018 and Dec 2024, across 48 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 39% of everything it billed.
33Billing provider infoCRUZ, CARLOS
ALEXANDRIA, VA 22314
ALEXANDRIA, VA 22314
33aNPI1265452338assigned 07/20/2006
33bProvider typePediatrics Physician
28Total paid$1.48M
24GClaims39,618
24DCodes billed48
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#103 of 817
Median peer was paid$29K
This provider vs. median50×
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 | 3,593 | $142K | |
| 2019 | 4,945 | $183K | |
| 2020 | 6,298 | $219K | |
| 2021 | 6,572 | $230K | |
| 2022 | 5,961 | $217K | |
| 2023 | 6,252 | $243K | |
| 2024incomplete | 5,997 | $243K |
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 | 39% | 9,744 | 8,693 | $581K |
| 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 | 13% | 2,348 | 2,242 | $198K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 9.7% | 1,903 | 1,893 | $144K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.4% | 1,633 | 1,621 | $124K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 7.2% | 1,276 | 1,268 | $106K |
| 92552 | 4.1% | 2,188 | 2,180 | $60K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.1% | 624 | 600 | $46K |
| 90686 | 1.5% | 1,862 | 1,799 | $22K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.5% | 1,386 | 1,380 | $22K |
| 92551 | 1.1% | 1,691 | 1,665 | $16K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 1,190 | 1,140 | $16K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.1% | 1,072 | 1,046 | $16K |
36 more codes
| 90651 | 1.1% | 360 | $16K | |
| 90670 | <1% | 505 | $14K | |
| 96127 | <1% | 1,625 | $14K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 365 | $9K |
| 0001A | <1% | 206 | $8K | |
| 0002A | <1% | 168 | $7K | |
| 99173 | <1% | 2,509 | $6K | |
| 90647 | <1% | 484 | $6K | |
| 99177 | <1% | 1,321 | $6K | |
| 90620 | <1% | 129 | $5K | |
| 90734 | <1% | 145 | $5K | |
| 90680 | <1% | 140 | $3K | |
| 90656 | <1% | 216 | $3K | |
| 90688 | <1% | 240 | $3K | |
| 96160 | <1% | 1,489 | $3K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 71 | $3K |
| 99000 | <1% | 748 | $2K | |
| 90677 | <1% | 50 | $2K | |
| 90716 | <1% | 71 | $2K | |
| 86580 | <1% | 217 | $2K | |
| 90633 | <1% | 107 | $1K | |
| 90707 | <1% | 69 | $1K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 321 | $1K |
| 94760 | <1% | 601 | $1K | |
| 0003A | <1% | 17 | $680.00 | |
| 90700 | <1% | 58 | $645.86 | |
| 90687 | <1% | 51 | $574.75 | |
| 2015F | <1% | 43 | $370.00 | |
| 90710 | <1% | 12 | $346.03 | |
| 96161 | <1% | 160 | $293.08 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 21 | $265.51 |
| 99050 | <1% | 40 | $244.60 | |
| 90715 | <1% | 13 | $225.64 | |
| 90723 | <1% | 13 | $211.15 | |
| 90713 | <1% | 15 | $165.55 | |
| 97802 | <1% | 101 | $32.15 |
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.