Physician
Gomez Cruz, Michelle
Gomez Cruz, Michelle was paid $1.17M by Medicaid between Jan 2018 and Dec 2024, across 9 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 75% of everything it billed.
33Billing provider infoGOMEZ CRUZ, MICHELLE
SAN JUAN, PR 00936
SAN JUAN, PR 00936
33aNPI1952572067assigned 03/17/2008
33bProvider typePediatric Endocrinology Physician
28Total paid$1.17M
24GClaims16,761
24DCodes billed9
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatric Endocrinology Physician providers in Puerto Rico
Rank by total paid#1 of 10
Median peer was paid$118K
This provider vs. median9.9×
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 | |
|---|---|---|---|
| 2018 | 2,297 | $90K | |
| 2019 | 2,277 | $115K | |
| 2020 | 2,679 | $165K | |
| 2021 | 2,306 | $156K | |
| 2022 | 1,566 | $87K | |
| 2023 | 2,422 | $223K | |
| 2024incomplete | 3,214 | $330K |
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 | 75% | 11,991 | 10,162 | $876K |
| 99443 | 15% | 2,929 | 2,849 | $174K | |
| 99241 | 5.5% | 1,114 | 1,052 | $64K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.4% | 115 | 73 | $16K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.3% | 192 | 190 | $15K |
| 99242 | 1.1% | 244 | 218 | $13K | |
| 99201 | <1% | 108 | 93 | $5K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 28 | 28 | $2K |
| 95251 | <1% | 40 | 40 | $975.53 |
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.