NPI: 1497881882 · ISABELA, PR 00662 · Eyewear Supplier · NPI assigned 02/27/2007
| Authorized Official | HERNANDEZ, JORGE (DIR. OF SPECIALTY DIVISION) |
| NPI Enumeration Date | 02/27/2007 |
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 |
| 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 |
| NORTHSIDE HOSPITAL, INC. | ATLANTA | GA | $953.17 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,678 | $37K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 766 | 410 | $26K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 439 | 255 | $8K |
| V2750 | Anti-reflective coating, per lens | 265 | 146 | $2K |
| V2744 | Tint, photochromatic, per lens | 75 | 39 | $773.00 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 108 | 53 | $415.50 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 25 | 13 | $110.00 |