Cruz-Martinez, Wilfredo
Cruz-Martinez, Wilfredo was paid $241K by Medicaid between Jan 2018 and Nov 2024, across 14 billing codes. Its largest line is 92004, Ophthalmological services: medical examination and evaluation, comprehensive, new patient — 28% of everything it billed.
33Billing provider infoCRUZ-MARTINEZ, WILFREDO
CAGUAS, PR 00725
CAGUAS, PR 00725
33aNPI1710913538assigned 06/23/2006
33bProvider typeOptometrist
28Total paid$241K
24GClaims7,103
24DCodes billed14
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Optometrist providers in Puerto Rico
Rank by total paid#46 of 299
Median peer was paid$40K
This provider vs. median6.0×
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 | 1,765 | $62K | |
| 2019 | 1,349 | $43K | |
| 2020 | 1,122 | $43K | |
| 2021 | 1,047 | $32K | |
| 2022 | 703 | $16K | |
| 2023 | 294 | $11K | |
| 2024incomplete | 823 | $33K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 28% | 985 | 931 | $67K |
| 92015 | Determination of refractive state | 27% | 3,180 | 2,781 | $65K |
| 92002 | 18% | 1,123 | 976 | $44K | |
| V2020 | Frames, purchases | 14% | 541 | 493 | $34K |
| 92250 | 8.4% | 659 | 438 | $20K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 2.6% | 145 | 137 | $6K |
| 92060 | 1.2% | 88 | 86 | $3K | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 17 | 12 | $544.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 17 | 12 | $544.00 |
| V2750 | Anti-reflective coating, per lens | <1% | 29 | 24 | $68.00 |
| V2744 | Tint, photochromatic, per lens | 0% | 53 | 53 | $0.00 |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 0% | 64 | 64 | $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.