Physician
Edgar T. Dela Cruz M.D., INC.
Edgar T. Dela Cruz M.D., INC. was paid $168K by Medicaid between Jan 2018 and Dec 2024, across 22 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 41% of everything it billed.
33Billing provider infoEDGAR T. DELA CRUZ M.D., INC.
HONOLULU, HI 96819
HONOLULU, HI 96819
33aNPI1821293796assigned 06/19/2007
33bProvider typePediatrics Physician
28Total paid$168K
24GClaims21,900
24DCodes billed22
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Hawaii
Rank by total paid#10 of 76
Median peer was paid$21K
This provider vs. median8.0×
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 | 3,839 | $25K | |
| 2019 | 3,710 | $21K | |
| 2020 | 2,296 | $13K | |
| 2021 | 2,906 | $12K | |
| 2022 | 3,730 | $21K | |
| 2023 | 2,886 | $35K | |
| 2024incomplete | 2,533 | $41K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 41% | 5,036 | 4,288 | $69K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 20% | 3,547 | 3,124 | $33K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 11% | 7,114 | 5,116 | $18K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 8.9% | 424 | 409 | $15K |
| 99441 | 7.0% | 1,849 | 1,040 | $12K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.1% | 404 | 385 | $5K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.3% | 239 | 229 | $4K |
| 99072 | 2.2% | 758 | 632 | $4K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.9% | 114 | 106 | $3K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.5% | 153 | 146 | $3K |
| 87428 | <1% | 35 | 27 | $2K | |
| 90480 | <1% | 20 | 19 | $698.88 |
10 more codes
| 90461 | <1% | 317 | $283.85 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 60 | $154.05 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 349 | $151.28 |
| 86580 | <1% | 34 | $60.98 | |
| 90686 | <1% | 1,045 | $22.61 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 13 | $7.38 |
| 90687 | <1% | 12 | $0.01 | |
| 90651 | 0% | 14 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 242 | $0.00 |
| 90688 | 0% | 121 | $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 officialDELA CRUZ, EDGAR (PRESIDENT)