Providers
CARMINA CARGO CRUZ, M.D.
NPI 1497859755, individual, Lancaster, SC, Pediatrics
5
Evidence tier
informational
score 31 of 100, rank 10843, $1.8M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CARMINA CARGO CRUZ, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | September 8, 2006, last updated October 30, 2012 |
| Practice location | 1228 COLONIAL COMMONS CT, SUITE 231, Lancaster, SC 29720-2200, 803-289-5437 |
| Specialties | Pediatrics (208000000X, primary, license 20230 SC) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $3.2M | 54% | $78 | $44 (top 5% from $110) | 87th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $499K | 8% | $102 | $60 (top 5% from $133) | 86th percentile | |
| 99392 | Medicaid service code | $377K | 6% | $100 | $78 (top 5% from $124) | 82nd percentile | |
| 99391 | Medicaid service code | $315K | 5% | $93 | $76 (top 5% from $126) | 75th percentile | |
| 99393 | Medicaid service code | $261K | 4% | $102 | $78 (top 5% from $121) | 84th percentile | |
| 90460 | Administration of first vaccine or toxoid component with counseling (18 years or younger) | $220K | 4% | $19 | $26 (top 5% from $54) | 32nd percentile | |
| 99394 | Medicaid service code | $220K | 4% | $111 | $83 (top 5% from $128) | 85th percentile | |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | $154K | 3% | $42 | $33 (top 5% from $45) | 89th percentile |
In this area
3 providers in Lancaster County, SC carry an indicator in the public record, with $6.0M at stake between them. The most common is more hours than a day holds, on 2 of them, followed by named in an enforcement record on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | TRANSFORMATION SERVICES Lancaster, SC, ranked 203 | $41K |
|
| 5 | EBENEZER MANTE Lancaster, SC, ranked 9890 | $5.5M |
|
| 5 | CRYSTAL MAXWELL Fort Mill, SC, ranked 10294 | $431K |
|
Recent enforcement in SC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedMar 11, 2026
Former Greenville CEO, Employees Indicted in Multi-Million Dollar Health Care Fraud Scheme
The defendants submitted false claims to health care benefit programs for individual COVID-19 tests that had actually been pooled for combined processing and manipulated test processing software, billing for tests that were virtually worthless and ineligible for reimbursement.
DOJSentencedFeb 25, 2026
Lancaster Trio Sentenced for Health Care Fraud Conspiracy
An excluded Medicaid provider and his wife established Transformation Services in her name to bill Medicaid for behavioral health services that were overlapping, not rendered individually, and provided by unlicensed therapists, defrauding Medicaid of nearly $250,000.
DOJIndictedNov 18, 2025
Florida Man Indicted for Health Care Fraud, Wire Fraud in Durable Medical Equipment Scheme
Weinberger, who was excluded from Medicare, allegedly concealed his ownership and control of a Medicare-enrolled durable medical equipment company through a false enrollment document and, with coconspirators, used call centers to generate doctors' orders for orthotic braces and submit approximately $6.7 million in false and fraudulent claims obtained through kickbacks and bribes, medically unnecessary, or otherwise ineligible for reimbursement.
DOJCivil judgmentJul 17, 2025
United States and the States of Georgia, Colorado, and South Carolina Obtain $114.5M in Judgments in a Sprawling Cancer Genetic Testing Lab Scheme
Premier Medical, its owner and compliance vice president paid kickbacks to Freedom Medical Labs and its marketers, who collected DNA samples from Medicaid beneficiaries in public spaces and purchased telemedicine physician orders, to bill Medicaid for medically unnecessary cancer genetic testing.
DOJIndictedJun 30, 2025
S.C. Cases Among Hundreds Announced in National Health Care Fraud Takedown
Two defendants were charged with submitting false claims to Medicare and Medicaid for durable medical equipment that was not delivered or authorized, and with billing the Veterans Administration for massage therapy services not rendered.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.