Managed care
Clinica Oftalmica De LA Montana, C.S.P.
Clinica Oftalmica De LA Montana, C.S.P. was paid $1.99M by Medicaid between Jan 2018 and Dec 2024, across 19 billing codes. Its largest line is 92014, Ophthalmological services: medical examination and evaluation, comprehensive, established patient — 58% of everything it billed.
33Billing provider infoCLINICA OFTALMICA DE LA MONTANA, C.S.P.
AIBONITO, PR 00705
AIBONITO, PR 00705
33aNPI1457328312assigned 02/28/2006
33bProvider typeExclusive Provider Organization
28Total paid$1.99M
24GClaims27,498
24DCodes billed19
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Exclusive Provider Organization providers in Puerto Rico
Rank by total paid#3 of 19
Median peer was paid$250K
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 | 4,290 | $256K | |
| 2019 | 4,379 | $251K | |
| 2020 | 4,604 | $305K | |
| 2021 | 4,441 | $344K | |
| 2022 | 4,035 | $291K | |
| 2023 | 3,426 | $269K | |
| 2024incomplete | 2,323 | $273K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 58% | 12,574 | 11,078 | $1.16M |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 14% | 429 | 392 | $274K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 10% | 1,663 | 1,416 | $206K |
| 92015 | Determination of refractive state | 9.2% | 6,062 | 5,342 | $183K |
| 92002 | 2.9% | 1,216 | 1,047 | $58K | |
| 92136 | 1.7% | 549 | 500 | $33K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 1.3% | 830 | 706 | $26K |
| 92250 | <1% | 607 | 493 | $20K | |
| 92202 | <1% | 1,183 | 1,002 | $8K | |
| 92083 | <1% | 125 | 106 | $6K | |
| 76514 | <1% | 476 | 375 | $4K | |
| 92226 | <1% | 1,210 | 644 | $2K |
7 more codes
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 officialSANTIAGO-PAGAN, LUIS (PRESIDENT)