Fernandez-Cruz, Carlos

Fernandez-Cruz, Carlos was paid $416K by Medicaid between Nov 2021 and Nov 2024, across 8 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 28% of everything it billed.

33Billing provider infoFERNANDEZ-CRUZ, CARLOS
SAN JUAN, PR 00909

33aNPI1699192765assigned 03/26/2014

33bProvider typeGastroenterology Physician

28Total paid$416K

24GClaims3,880

24DCodes billed8

24AFirst – last monthNov 2021 – Nov 2024

Compared with peers

Next to other Gastroenterology Physician providers in Puerto Rico

Rank by total paid#31 of 107

Median peer was paid$47K

This provider vs. median8.9×

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
2021	26	$1K
2022	846	$87K
2023	1,459	$169K
2024incomplete	1,549	$159K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	28%	350	321	$115K
45380	Colonoscopy, flexible; with biopsy, single or multiple	22%	296	276	$92K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	17%	839	783	$71K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	16%	1,008	925	$67K
99070		10%	919	737	$43K
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)	3.0%	311	196	$13K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	2.7%	21	12	$11K
99153	Mod sedat endo service >5yrs	<1%	136	74	$3K

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.