Hernandez, Gustavo

Hernandez, Gustavo was paid $162K by Medicaid between Feb 2018 and Apr 2024, across 10 billing codes. Its largest line is 92012, Ophthalmological services: medical examination and evaluation, intermediate, established patient — 91% of everything it billed.

33Billing provider infoHERNANDEZ, GUSTAVO
SAN JUAN, PR 00921

33aNPI1376620468assigned 11/01/2006

33bProvider typeOphthalmology Physician

28Total paid$162K

24GClaims4,499

24DCodes billed10

24AFirst – last monthFeb 2018 – Apr 2024

Compared with peers

Next to other Ophthalmology Physician providers in Puerto Rico

Rank by total paid#72 of 141

Median peer was paid$163K

This provider vs. median1.0×

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	1,019	$26K
2019	1,167	$33K
2020	897	$33K
2021	513	$22K
2022	435	$23K
2023	375	$20K
2024incomplete	93	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	91%	2,458	2,091	$147K
92015	Determination of refractive state	6.0%	282	232	$10K
92202		1.1%	582	496	$2K
92226		<1%	705	325	$1K
92083		<1%	225	203	$978.00
92002		<1%	22	16	$711.24
92134		<1%	86	82	$343.70
92250		<1%	39	39	$267.54
92133		<1%	75	60	$143.95
92020		<1%	25	25	$99.22

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.