Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Puerto Rico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Puerto Rico only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Puerto Rico (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Michelle Gomez Cruz (NPI 1952572067)

Field	Value
Entity Type	Individual
Organization	Michelle Gomez Cruz
Address	San Juan City Hospital
City	San Juan
State	PR
ZIP	00936
Taxonomy	Pediatric Endocrinology Physician
NPI Enumerated	March 17, 2008

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	11,990	$70	$875.3K
99443	N/A	2,930	$60	$172.8K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	1,110	$60	$64.6K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	120	$140	$15.9K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	190	$80	$14.6K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	240	$50	$13.2K
99201	Deleted code, effective Jan. 1, 2021	110	$50	$5.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30	$60	$1.7K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	40	$20	$960

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

Claims Volume vs. Puerto Rico Distribution

Michelle Gomez Cruz — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	233	280	210	$30	$43.8K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	11	900	360	$30	$42.5K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	632	1,400	160	$50	$29.6K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	247	530	100	$70	$22.9K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	16	100	180	$30	$18.4K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	40	90	170	$30	$18K
99443	N/A	13	210	110	$10	$9.8K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	10	10	100	$30	$8.5K
99201	Deleted code, effective Jan. 1, 2021	76	150	100	$20	$4.6K

Nearby Providers

Other providers in the same ZIP code as Michelle Gomez Cruz, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Municipality Of San Juan	PR	Multi-Specialty Clinic/Center	$0	$4.5M
Ffv Id Med Group Psc	PR	Infectious Disease Physician	$0	$3M
Omayra Gonzalez	PR	Hematology & Oncology Physician	$2.9K	$1.6M
Cardiovascular Anesthesia De Puerto Rico, Psc	PR	Anesthesiology Physician	$0	$1.1M
Recinto De Ciencias Medicas	PR	Dermatology Physician	$0	$1.1M
Recinto De Ciencias Medicas	PR	Otolaryngology/Facial Plastic Surgery Physician	$0	$881.7K
Recinto De Ciencias Medicas	PR	Cardiovascular Disease Physician	$0	$842.2K
Recinto De Ciencias Medicas	PR	Endocrinology, Diabetes & Metabolism Physician	$0	$693.7K
Juan Aviles	PR	Internal Medicine Physician	$15K	$276.9K
Jose Kareh Cordero	PR	Cardiovascular Disease Physician	$7.3K	$57.1K

Michelle Gomez Cruz — Billing Profile & Reimbursement Data

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Michelle Gomez Cruz — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References