NORTHSIDE HOSPITAL, INC.

NPI: 1457396079 · ATLANTA, GA 30342 · General Acute Care Hospital · NPI assigned 06/18/2006

$953.17

Total Medicaid Paid

3,488

Total Claims

1,291

Beneficiaries

Codes Billed

2022-03

First Month

2024-10

Last Month

Provider Details

Authorized Official	HERNANDEZ, JORGE (VP ADMIN. SVCS/CCO)
NPI Enumeration Date	06/18/2006

Other providers sharing the same authorized official: HERNANDEZ, JORGE

Provider	City	State	Total Paid
GWINNETT PHYSICIAN GROUP, LLC	LAWRENCEVILLE	GA	$8.28M
NORTH ATLANTA PROFESSIONAL SERVICES LLC	ATLANTA	GA	$849K
GEORGIA SURGICAL PROFESSIONAL SERVICES, LLC	ATLANTA	GA	$709K
WALMART #2067	MAYAGUEZ	PR	$98K
WALMART #2501	BAYAMON	PR	$59K
WALMART #2085	ISABELA	PR	$37K
PULMONARY MEDICINE ASSOCIATES, P.A.	OCOEE	FL	$4K
NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC	ATLANTA	GA	$3K
JORGE L HERNANDEZ MD PA	BRADENTON	FL	$3K
WALMART #1854	HATILLO	PR	$999.90

Code	Description	Claims	Beneficiaries	Total Paid
80053	Comprehensive metabolic panel	1,214	427	$375.03
85025	Blood count; complete (CBC), automated, and automated differential WBC count	1,647	556	$326.50
G0463	Hospital outpatient clinic visit for assessment and management of a patient	117	55	$136.99
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	23	12	$42.29
36415	Collection of venous blood by venipuncture	433	214	$37.88
83735		25	12	$18.17
83615		29	15	$16.31