primary physicians / medicos primarios

Transcripción

305-262-1610
TABLA DE CONTENIDOS
Membership Agreement / Acuerdo de Membrecia..........................................................7
Welcome Letter / Carta de Bienvenida...............................................................................8
Terms and Conditions / Términos y Condiciones.............................................................9
How to Use Your Card? / ¿Cómo usar su tarjeta?..........................................................10
Primary and Specialist Physicians / Medicos Primarios y Especialistas ....................11
Primary Physicians Locations / Direcciones de los Medicos Primarios......................12
Gynecology & Obstetrics / Ginecologia y Obstetricia....................................................17
Pediatrics / Pediatria..........................................................................................................18
Primary and Specialist Providers Fees / Precios de los servicios medicos
primarios y especialistas...................................................................................................20
Medical Centers / Centros Medicos..................................................................................21
Specialist Physicians Locations / Direcciones de los Medicos Especialistas............25
Neurological Studies Fees / Precios de los estudios neurologicos..............................30
Urgent Care Centers / Centros de Cuidados de Urgencia.............................................35
Dental Services / Servicios Dentales................................................................................37
General Dentistry Fees / Precios de los servicios de Odontologia General.................38
Dental Specialties Fees / Precios de los Servicios Dentales por Especialidad...........43
Optical Services / Servicios Opticos................................................................................44
Optical Sevices Fees / Precios de los Servicios Opticos...............................................47
Clinical Laboratories / Laboratorios Clinicos..................................................................48
Laboratories Locations / Direcciones de los Laboratorios............................................49
Laboratory Services Fees / Precios de los Servicios de Laboratorio...........................50
Diagnostic and Radiology Centers / Centros de Diagnostico y Radiologia.................58
Diagnostic Centers Locations / Direcciones de los Centros de Diagnostico..............58
Diagnostic Services Fees / Precios de los Servicios de Diagnostico..........................61
Ancillary Services / Servicios Auxiliares........................................................................66
Durable Medical Supplies / Equipos Medicos Duraderos..............................................66
Orthopedic Supplies/ Suplementos Ortopedicos...........................................................67
Hearing Aids/ Suplementos Auditivos.............................................................................68
Transportation/ Transportacion........................................................................................69
Home Health and Physical Therapy / Servicios a domicilio y Terapia Fisica....................70
Diabetes Supply Services / Suplementos para la Diabetes...........................................72
Pharmacy Services / Servicios Farmaceuticos...............................................................73
Pharmacy Locations / Direcciones de las Farmacias.....................................................74
Pharmacy Services Fees / Precios de los Servicios de Farmacia.................................77
Cosmetology Services Fees / Precios de los Servicios de Cosmetologia...................82
Disclaimer of Liability
In consideration of the monthly payment fees to be paid to Med Plan by you or on your behalf, Med Plan agrees
to arrange for the delivery of health care services in accordance with and subject to the terms of the Agreement
entered into between you or on your behalf, and Med Plan. Med Plan, in so arranging for the delivery of health care
services and supplies, does not directly provide these services nor supply them. Rather, Independent Contractors
provide these services and supplies. The health care providers listed in this directory are not employees or agents
of MedPlan. MedPlan shall not be liable for any negligent act or omission committed by any of the providers listed
in this directory, or any of their employees or agents who may, from time to time provide medical services to you.
MedPlan expressly disclaims any agency relationship, actual or implied, with any health care provider. MedPlan
does not exercise any control or direction over the medical judgement or clinical decisions of any health care
provider listed in this directory and does not interfere with the physician patient relationship between you and any
health care provider. It is important for you to know when you enroll in MedPlan that the continued participation of
any one doctor, hospital or other provider cannot be guaranteed.
This directory is current as of date of publication. Some plan providers may have been added or removed from this
list after this directory was printed. To get the most up-to-date information about MedPlan providers in your area,
you can visit www.floridamedplan.com or call our Customer Service Department at 305-262-1610, Monday through
Friday, 9:00 am to 6:00 pm.
The fact that a provider is listed does not guarantee that they are still in the network or accepting new patients. The
“Plan Providers” listed in this directory have agreed to provide you with your health care coverage at fixed discounted
from their usual and customary pricing rate. Members are limited to only those providers that are affiliated to the
MedPlan Network of Providers. Participating physicians and other providers listed in this directory or on our website
www.floridamedplan.com are not agents, employees or partners of MedPlan or any of its subsidiaries. MedPlan is
not a medical services provider, a medical insurance plan nor an HMO. MedPlan does not control nor endorse the
judgement or clinical treatment recommendations made by the physicians or other providers listed in our directory, or
in our website www.floridamedplan.com nor those that you chose to select. All MedPlan providers are independent
contractors. You may go to any of our plan providers listed in this directory; however some services may require a
prescription or medical treatment plan provided by a licensed medical physician. If you have been going to one plan
provider, you are not required to continue going to that same provider.
Providers are independent.
Providers are listed in this directory by the type of provider: Primary Care Physicians (PCP), Family Medicine,
Specialists, Urgent Care Centers, Diagnostic Centers, Laboratory, Pharmacy, Optical, Dental, and Durable Medical
Equipment providers.
Within each provider type, providers are lsited by COUNTY. You can also visit www.floridamedplan.com or call
Customer Care Department at 305-262-1610.
Our providers are paid on a contracted discount fee-for-service basis by you at the time the service is rendered.
If you use Non-Plan providers, understand that Non-Plan providers are not part of MedPlan network. In that case,
you will have to pay the provider their usual and customary fees which are significantly higher than the contracted
rate MedPlan has with its in-network providers. care or services you get from non-plan providers will NOT be
covered. MedPlan services are limited to the counties that MedPlan has providers and services contracted in. Any
services provided outside MedPlan service areas will not be at the contract price.
You have the right to get timely access to plan providers and to all discounts covered by the plan. Timely access
means that you can get appointments and services within a reasonable period of time. You have the right to get full
information from your providers when you go for medical care. You have the right to participate fully in decisions
about your healthcare. You have the right to refuse care.
MedPlan does not limit its members from visiting any provider contracted by MedPlan. You can visit any provider
or service without any limitation or need for referral. MedPlan does however recommend that the member choose
a primary care physician from our directory to be the gate keeper or central coordinator for all referrals to specialist
and services.
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This insures that the member’s service ordered or more importantly that the member is not
prescribed medication that can be contraindicated to another medication ordered by an unknown provider.
Also please note due to the nature of health care delivery systems it is sometimes necessary to have a written
prescription or medical treatment plan in order to have services rendered by certain MedPlan providers. These services
are Pharmacy, Durable Medical Equipment, Laboratory Services, Physical Therapy and Diagnostic Radiology services.
Please visit your Primary Care Provider or Specialist to get the proper treatment orders before visiting any MedPlan
support service providers listed above. Services such as Dental and Optical can be accessed directly by the member at
anytime without providing notification to your PCP. Please note that any medical emergency should be directed to the
nearest Urgent Care Center or local Hospital Emergency Room.
The following directory is constantly changing and is therefore subject to change without notice. For current and update
providers information please visit our website: www.floridamedplan.com
Excepción de responsabilidad civil.
MedPlan, en consideración al pago de su membrecía, está de acuerdo en ofrecerle el acceso a la red de proveedores
establecida que prestan sus servicios a nuestros miembros. MedPlan coordinará su primera cita con el proveedor que
usted elija dentro del directorio. MedPlan no asigna a ningún proveedor. Es responsabilidad del miembro elegir el médico
que le prestará los servicios. MedPlan no ofrece los servicios médicos directamente, sino a través de proveedores
independientes que proveen estos servicios y sus suplementos. Los proveedores que aparecen en este directorio no
son empleados o agentes de MedPlan. Los empleados o agentes de MedPlan no deben ser responsables legalmente
por alguna negligencia o acto de omisión cometida en cualquier momento por algún proveedor que aparezca en este
directorio. MedPlan específicamente no se responsabiliza en ningún momento y no tiene ninguna relación de agencia
con ningún proveedor médico. MedPlan no ejerce ningun control o dirección respecto a un criterio médico o decisión
clínica de algún proveedor del directorio ni interfiere en la relación entre el paciente y su médico. Es importante que
al convertirse en miembro de Med Plan, la persona sepa que no se le garantiza la continua participación de un doctor,
hospital, u otro proveedor.
Este directorio está vigente desde el día en que fue publicado. Es muy posible que a partir de ese dia se hayan
agregado o eliminado de la lista algunos proveedores. Para obtener una información actualizada de los proveedores en
su area, visítenos en www.floridamedplan.com o llame a nuestro Departamento de Servicio al Cliente, al 305-262-1610,
de Lunes a Viernes de 9:00 am a 6:00 pm.
El hecho de que un proveedor se encuentre en la lista no garantiza que todavía se encuentre en la red o que participe
consultando nuevos pacientes. Los proveedores listados en este directorio han acordado en proveerles a los miembros
de Med Plan sus servicios de cuidado a su salud con una tarifa fija que representa un Ahorro sobre la tarifa regular.
Usted puede ir a cualquiera de nuestros proveedores en este directorio y no necesita ser referido por el médico primario
que le atiende para visitar a un especialista dentro de la red, pero algunos de estos servicios, como son los exámenes
de laboratorio, radiología o diagnóstico sí requieren de una referencia por parte del doctor que le ordena el examen
o procedimiento. Si usted ha ido a uno de nuestros proveedores y no se siente satisfecho con sus servicios, usted
no está en la obligación de seguir visitándolo. Los miembros están limitados a los proveedores que están afiliados a
la red de MedPlan. Los proveedores participantes en este directorio o en www.floridamedplan.com no son agentes,
empleados o socios de MedPlan, ni ninguno de sus subsidios. MedPlan no es un proveedor de servicios médicos, ni
tampoco un plan de seguros médicos ni un HMO. MedPlan no apoya los diagnósticos ni los tratamientos médicos dados
por los proveedores participantes en la red de MedPlan listados en este directorio, ni en www.floridamedplan.com, ni
los proveedores escogidos por nuestros miembros.
Los proveedores son independientes.
Los proveedores en este directorio han sido clasificados según tipo de proveedor: Doctores primarios(PCP), Medicina
familiar, Especialistas, Centros de cuidados de urgencia, Centros de terapia física, Centros de diagnóstico, Laboratorios,
Cuidado médico en el hogar, Farmacias y Equipos médicos. Cada especialidad ha sido clasificada en sus respectivos
condados. Visítenos en www.floridamedplan.com o llámenos al Departamento de atención al cliente al 305-262-1610.
Nuestros proveedores tienen que ser pagados por usted a la hora de recibir sus servicios. MedPlan tiene varios tipos
de acuerdos contractuales con los proveedores que son comunes en los planes médicos.
Si usted usa un proveedor que no forma parte de la red de MedPlan, usted no recibirá la tarifa negociada y tendrá que
pagar la tarifa completa que exija ese proveedor.
Los descuentos de MedPlan no se aplican si usted viaja fuera de las areas de servicios.
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Usted tiene derecho al acceso de la red de nuestros proveedores y a todos los descuentos disponibles en el plan.
Esto significa que usted puede obtener citas y servicios en un tiempo razonable. Usted tiene derecho a recibir de
su proveedor toda la información referente a su cuidado o tratamiento médico, a participar completamente en las
decisiones sobre su salud, y al derecho de rehusar su tratamiento médico.
MedPlan no limita a sus miembros a visitar a cualquier proveedor que pertenezca a su red. Usted puede visitar
a cualquier proveedor o servicio sin ningún tipo de limitación o necesidad de derivación. MedPlan recomienda,
sin embargo, que el miembro elija un médico de atención primaria de nuestro directorio para ser el coordinador
central para todas las derivaciones al especialista y servicios.
Esto asegura que los servicios de los miembros se coordinen y el miembro reciba la atención
médica adecuada con el pleno conocimiento de su PCP. Esto evitará la duplicación de los servicios solicitados,
o más importante aún, que al miembro no se le prescriba un medicamento que puede estar contraindicado con
otro medicamento ordenado por un proveedor desconocido. Tambien tenga en cuenta que debido a la naturaleza
de los sistemas de prestación de asistencia sanitaria, a veces es necesario tener una prestación escrita o plan
de tratamiento médico a fin de que los servicios prestados por determinados proveedores de MedPlan estén
prescritos correctamente. Estos servicios son Farmacia, Equipo médico duradero, Laboratorio, Radiología
diagnóstica, Terapia física, etc. Visite a su proveedor de atención primaria o especialista para obtener las órdenes
de un tratamiento adecuado antes de visitar cualquier proveedor de los antes mencionados.
El siguiente directorio está sujeto a modificaciones constantes y puede cambiar sin previo aviso. Para más
información actualizada visítenos en www.floridamedplan.com
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MEMBERSHIP AGREEMENT
MED PLAN LLC
Attn: Compliance Department
7200 NW 7th ST, Suite 100
Miami, Fl. 33126
For assistance and plan information call: 305-262-1610. or plan information, to change your method of payment, to
add family members or for any other assistance please call the customer service number located on the back of your
membership card. All documents contained herein (i.e. Terms and Conditions and Member Benefits) are hereby attached
to and made a part of the Membership Agreement. Disclosures:
1. This plan is not a health insurance policy.
2. This plan provides discounts at certain health care providers for medical services.
3. This plan does not make payments directly to the providers of medical services.
4. The plan member is obligated to pay for all health care services but will receive a discount from those
health care providers who have contracted with the discount plan organization.
Terms and Agrements:
To terminate or cancel the member agreement please call the number above or send a written cancellation notice to the
Discount Medical Plan Organization at the address provided above. This agreement can be cancelled for non-payment.
If the discount medical plan organization cancels a membership for any reason other than nonpayment of fees by
the member, the discount medical plan organization shall make a pro rata reimbursement of all periodic charges to
the member. If you cancel for any reason within 30 days after the effective date, you will receive a full refund of paid
membership fee,
excluding the one-time application fee.
Legal Notice:
Med Plan is not an insurance company. Med Plan offers discounts on some health providers for their medical services.
Med Plan does not make direct payments to the providers of medical services. The members of Med Plan are required to
pay for all the health care services, but will have a discount on the health providers contracted.
ACUERDO DE MEMBRECIA
Para asistencia e información sobre el plan por favor llame al 877-334-1634. Para información del plan, para cambiar la
forma de pago, para agregar miembros de la familia o cualquier otro tipo de asistencia llame al Departamento de Atencion al cliente situado en la parte superior de su tarjeta de membrecia: 305-262-1610.
Todos los documentos incluidos (beneficios de los miembros, términos y condiciones de estos) se mostrará en estas
páginas y forma parte del Acuerdo de Membrecía. Para cancelar su membrecía, por favor llame al número indicado
anteriormente y envíe una notificacion con su puño y letra explicando los motivos de su cancelación al Departamento de
Servicio al Cliente de MedPlan.
Por favor envíe las tarjetas de membrecía de cada miembro junto con la carta de cancelación, esta carta debemos recibirla antes de los 30 días despues que se afilió a la Compañía.
Este acuerdo puede ser cancelado por no pagar su mensualidad. Si el Departamento de Servicios al Cliente de MedPlan
cancela su membrecía por cualquier razón que no sea el pago de su mensualidad MedPlan le hará el reembolso con la
suma de los días no utilizados.
Proceso de cancelación:Si usted cancela su membrecía por cualquier razón dentro de los 30 días siguientes a la fecha
de efectividad, usted recibirá un rembolso completo de su pago, excepto la cuota de inscripción de $30.00.
Aviso Legal
Med Plan no es un seguro médico. Med Plan proporciona descuentos con los proveedores de la salud que han sido
contratados. Med Plan no efectúa pagos directamente a los proveedores de los servicios médicos. Los miembros de
Med Plan están obligados a pagar por todos los servicios Médicos, pero recibirán un descuento de los provedores de
salud que han sido contratados.
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WELCOME
We are pleased to welcome you to Med Plans Premier Plus benefits program.
You can enjoy savings on your health care needs by using your new membership card,
which is enclosed in your new member packet.
We help in caring for your health and your family.
For your convenience we have enclosed with your membership kit a complete
directory of all Med Plans contracted participating providers. Our Member Services
Department is also available during business hours to assist you in locating additional
providers in your area. Just call our toll-free number located on the back of you
membership card, or you may go to the internet at www.floridamedplan.com at any
time day or night. If your favorite provider is not already on our program, you may
nominate them to Members Services for additional follow-up.
Please keep in mind that your membership is NOT insurance, so it is simple and easy
to use. You can begin using Med Plans complete list of services immediately as many
times as needed without need of prior approvals. When you present your card with your
ID to a participating provider you will have immediately access to the exclusive pricing
Med Plan members receive at time of service.
We also understand that your family’s health is your number one priority, so all legal dependents you have enrolled as part
of your plan will receive their own card that they need to take with them to access the same pricing and services.
If for any reason you are not satisfied with this program or are having problems in accessing services, pleased call the
number on the back of your card for prompt response to any issue.
We encourage our new members to please take a moment to familiarize yourself with the instructions in this booklet so that
you can better understand how Med Plan works and what is required to access the different services.
Please remember the more informed you are, the better your experience with Med Plan will be and the more often you will
take advantage of the tremendous serves and exclusive pricing that Med Plan offers you. Remember your Health is the
most precious gift you have. Let Med Plan help protect it.
BIENVENIDOS
Nos complace darle la bienvenida a un programa de beneficios de primer nivel. Puede disfrutar de ahorros en sus
necesidades de salud mediante el uso de su nueva tarjeta de membrecía, que se incluye en su paquete de nuevo
miembro.
Le ayudamos en el cuidado de su salud y la de su familia
Para su comodidad, le proporcionamos una guía de proveedores contratados por Med Plan que incluyen, direcciones
y números de teléfono. Nuestro Departamento de Servicios también está disponible durante horas de oficina para
ayudarle a encontrar proveedores en su área y ayudarlos a conseguir una cita o usted puede visitar nuestro sitio Web:
www.floridamedplan.com a cualquier hora del día o llamar al (305) 262-1610 en horas laborables.
Si su Doctor favorito no pertenece a nuestra Red, usted puede llamar a Med Plan al Departamento de Relación con
proveedores y nosotros lo vamos a contactar, haciendo todo lo posible por lograr que se una a nuestra Red y continúe
brindándole los servicios que usted se merece a través de nuestro Plan Médico.
Med Plan en ningún caso le garantiza el resultado de esta Gestión.
Por favor, tenga en cuenta que su membrecía NO ES UN SEGURO MEDICO, por lo que es simple y fácil de usar. Usted
puede usar la tarjeta inmediatamente y tantas veces como sea necesario. Al presentar su tarjeta a usted se le aplicará
inmediatamente la tarifa de descuento en el momento de la compra o servicio.
En Med Plan, sabemos que la salud de su familia es su prioridad. Todos los dependientes legales podrán utilizar su
tarjeta de membrecía, o solicitar tarjetas adicionales en caso de pérdida para usted o algún miembro de la familia con
su propio nombre sin costo alguno, simplemente llamando al Departamento de Servicios al cliente. Si por alguna razón
usted no está satisfecho con este plan, llame al número en la parte posterior de su tarjeta para su reclamo.
¡PORQUE SU SATISFACCION ESTA GARANTIZADA!
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TERMS AND CONDITIONS
1. Primary member is defined as the person who is responsible for the monthly payments for membership fees and is of
legal age. The primary member, spouse, and all legal dependents listed on the enrollment application can access the
services and exclusive pricing at Med Plan Contracted service providers.
2. Participating provider may be added or removed from the respective network in which they are associated with. These
changes are made in best interest of our members. Updated Provider information will be made availableonline at
www:floridamedplan.com
3. Companies contracted to provide benefits and services in this program are not a licensed insurer, health maintenance
organization (HMO), or any other underwriters of healthcare services.
No portion of any provider fees will be reimbursed or otherwise paid.
4. The exclusive Med Plan pricing contained herein may not be used in conjunction with any other medical plan or discount
program. All listed or quoted prices are current prices from participating providers and subject to change without notice.
From time to time, certain providers may offer products and /or services to the general public at prices lower than the prices
available through this program. In such event, members will be charged the lowest price.
5. Providers are subject to change without notice and programs may vary in some states. This is a discount membership
program only, not insurance, and may be discounted or modified at anytime.
6. Savings are based upon the provider’s normal fees. Actual savings will vary depending upon location and specific
services or products purchased.
7. This discount medical plan does not warrant professional services, nor is it responsible for the quality of care received.
This program makes no warranties expressed or implied concerning services or care provided by participating providers.
8. (30) Day Money Back Guarantee: If you cancel for any reason within 30 days, you will receive a full refund. Nonrefundable one time fees will be disclosed at time of application.
9. All applicable limitations, exclusions and exceptions of the discount medical plan benefits are listed
with each benefit description.
TERMINOS Y CONDICIONES
1. El titular es definido como miembro principal, el cónyuge y todos los dependientes legales adicionales contaran
automáticamente con los mismos beneficios que se ofrecen en el plan.
2. En cualquier momento, un proveedor participante puede ser eliminado de la red en la que está asociado con el plan.
3. Las compañías proveedoras de beneficios y descuentos en este plan no son de seguro, suscriptor de servicios de salud.
Ninguna organización de la salud (HMO), u otro parte de cualquier proveedor de los honorarios será reembolsado o pagado
de otra manera.
4. Los descuentos que figuran en este documento no pueden ser utilizado en combinación con cualquier otro plan de
descuento médico o programa de descuentos. Todos los precios cotizados son los precios actuales de los proveedores
participantes y están sujetos a cambios sin previo aviso.
De vez en vez, algun proveedor puede ofrecer productos y / o servicios al público en general a precios inferiores a los
precios disponibles en este programa. En Tal caso, se cobrará el precio más bajo.
5. Los proveedores están sujetos a cambios sin previo aviso, los programas pueden variar en algunos términos. Este es un
programa de membrecía de descuento, no un seguro medico, y puede ser cancelado o modificado en cualquier momento.
6. Los ahorros se basan en las tasas normales del proveedor. Los ahorros reales variarán dependiendo de la localización
de los servicios específicos o productos comprados.
7. Med Plan no es un seguro médico. Med Plan proporciona descuentos con los proveedores de la salud que han sido
contratados por servicios médicos. Med Plan no efectúa pagos directamente a los proveedores de servicios médicos.
Los miembros de Med Plan están obligados a pagar por todos los servicios de la atención de la salud, pero recibirán un
descuento de los proveedores contratados por Med Plan.
8. Los proveedores contratados por MED PLAN son los únicos responsables por el asesoramiento profesional y el
tratamiento administrado a los miembros. MED PLAN no se responsabiliza por los servicios, tratamientos o procedimientos
ofrecidos por los proveedores contratados.
9. Garantía de Reembolso por 30 Días: Si cancela por cual quier razón en el plazo de 30 días, usted recibirá un reembolso
completo de su mensualidad. Tasa no reembolsable se revelará en el momento de aplicación.
10. Este plan de descuentos médicos no garantiza los servicios profesionales, ni es responsable de la calidad de la
atención recibida. Este plan no ofrece ninguna garantía implícita relativa a los servicios o asistencia médica prestados por
los proveedores participantes.
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HOW TO USE YOUR MEMBERSHIP CARD
1. Keep your membership card with you at all times so it will be easily accessible to present at provider locations. Please
note that you must present your membership card so that the status of you membership can be verified before services are
provided and to qualify for Med Plan exclusive price at contracted provider locations.
2. When visiting your Physician and or Specialist you must present your Med Plan membership card with a picture ID so that
your eligibility can be verified at time of your visit to receive the exclusive pricing offered to Med Plan members
3. Med Plan has sent all persons covered in your plan their own membership cards. Each card has its own ID number
and must be shown to the provider so that the status of you membership can be verified before services are provided. If
the dependent is a minor then it is the responsibility of the “minors” parent or legal guardian to accompany the minor to all
provider visits and services.
4. To locate participating providers in your area, please refer to the Provider Directory provided in your “Membership Kit”.
This directory contains information on all Med Plan contracted providers including pricing for all covered services. Since
providers and services are being added monthly, Med Plan has created a website for our members to view all of their
membership information which includes updates and new services. To access this information online please call Med
Plans “Member Service Department” and ask for them to email you your username and password. For additional provider
locations, call the appropriate number on the back of your card or visit: www.floridamedplan.com
5. Please remember that Payment for all services must be made directly to the provider at time of service.
6. If you have any questions on how to use your membership, call our Member Services departments at the toll-free number
listed on your card for prompt, friendly service.
7. We are located at 7200 NW 7th street Suite 100, Miami FL 33126
(305) 262-1610. Our Offices are open Monday through Friday
9:00 a.m. to 5:00 p.m.
COMO USAR SU TARJETA DE MIEMBRO
Cuando usted visite a un proveedor (Ejemplo: Médico general o Especialista) usted deberá presentar su tarjeta de miembro
con una identificación con fotografía (ID) para que su elegibilidad pueda ser verificada en el momento de solicitar sus
servicios y pueda beneficiarse de las tarifas preferenciales exclusivas que aplican únicamente a los miembros de MedPlan.
Cuando usted visite a proveedor participante usted pagará una tarifa fija preferencial que ha sido establecida para los
miembros de MedPlan. Las Tarifas establecidas aparecen en este libro que ha sido incluido dentro del paquete de membrecía
que usted recibió. Por favor refiérase a la sección que corresponda dentro de este directorio.
Todos los servicios prestados en el consultorio de un médico de atención primaria o especialista usted lo pagará directamente
en el momento de recibir los servicios.
Solo los médicos y demás proveedores de la red que brindan sus servicios a nuestros miembros, honraran las tasas
establecidas. Los proveedores de la red tienen en su poder las mismas tarifas que usted tiene, esto le asegura que lo que
usted pagará no puedan ser alterados.
MedPlan no le asigna ningún proveedor, usted es libre de elegir dentro del directorio. La información detallada para localizar
a un proveedor, dirección, número telefónico, tarifa etc. se encuentra dentro del directorio médico que usted recibió. Usted
puede obtener esta información en cualquier momento visitando nuestra página web:
www.floridamedplan.com
Para coordinar su primera cita con un proveedor de la red usted puede elegir cualquiera de las siguientes opciones:
a) Llame directamente al proveedor que usted haya elegido.
b) Llame a nuestro departamento de atención al cliente al (877) 334-1634 y solicite que se le coordine la cita con el
doctor que usted haya elegido. En ese caso tenga a mano el nombre del doctor para que la asistencia sea efectiva
y rápida en función de sus necesidades.
Nos encontramos en 7200 NW 7th street Suite 100, Miami FL 33126
(305) 262-1610.
Nuestras oficinas estan abieras de Lunes a Viernes de 9:00 a.m. to 5:00 p.m.
10
PRIMARY PHYSICIANS AND SPECIALISTS
All services rendered at your primary care physicians office or Specialist will be paid directly to the provider at fix rates that
are completely disclosed inside this book. These prices are exclusive to Med Plan members and represent an average
savings of 70% percent off the Providers Usual and customary fees.
All prices cover service provided at your Physicians office which can include, routine X-rays, EKG’s, Ultrasounds and many
other services. Services vary from provider to providers depending on equipment each Physician or Specialist practice
elects to provide. It’s unlimited the access to Primary Care and Specialist Visits. No prior approval is needed.
Physician and Specialists address and phone numbers are located inside your Membership kit or on our website www.
floridamedplan.com. To schedule an appointment please call the provider you have chosen from the directory. If you need
assistance or cannot find a provider near you please call our Customer Service Department for assistance at 305-262-1610.
Only approved and contracted Med Plan Physicians and Specialists will honor the exclusive prices as
defined in the Pricing Guide included in your membership kit.
Any Diagnostic studies, Laboratory test, Prescription Medication or services ordered by a Med Plan contracted Physician or
Specialist must be performed or completed by a Med Plan approved and contracted provider. This will insure that the service
and its price are within the scope of the agreements Med Plan has in place with its approved service providers
If you need assistance in coordinating these services please feel free to contact our Customer Service Department at 305262-1610.
Note: If your favorite physician is not already a participating provider, Call our Provider Relation Department to nominate him
or her. Have the physicians name, address, and telephone number available when you call.
MEDICOS PRIMARIOS Y ESPECIALISTAS
Todas las tasas aplican a los servicios prestados en la oficina de los médicos que pueden incluir, rutina de Rayos X,
electrocardiogramas, ecografías y muchos otros servicios. Los servicios pueden estar disponibles o no, dependiendo el
equipo médico o especialista que usted pueda elegir. Tenga en cuenta que no todos reúnen las mismas condiciones de
equipamiento dentro de su consulta médica. Usted cuenta con visitas médicas ilimitadas y además tendrá la libertad de
visitar a cualquier médico especialista sin la necesidad de ser referido por su médico primario.
Cualquier estudio de Diagnóstico, Examen de Laboratorio, Medicamentos recetados u otro servicio deberá ser indicado
por un proveedor que haya sido aprobado o contratado por MedPlan. Esto asegura que el servicio que usted va a recibir
y la tasa que va a pagar esta dentro de los acuerdos que MedPlan ha establecido con los proveedores de la red. Si usted
necesita ayuda para coordinar estos servicios por favor contacte a nuestro departamento de servicio al cliente (877) 3341634.
Nota: Si su doctor favorito aun no es participante de nuestra red y desea que se integre para que pueda continuar con sus
servicios y adaptar nuestras tarifas preferenciales, por favor contacte a nuestro departamento de Relación con Proveedores
y ofrezca información precisa del doctor (Nombre, Dirección y Teléfono de su oficina) nosotros nos sentiremos complacidos
en contactarlo a mayor brevedad posible y lo invitaremos a que se una a nuestra Red.
11
PRIMARY PHYSICIANS / MEDICOS PRIMARIOS
Primary Care Physicians / Médicos Primarios
12
Miami - Dade
Esperanza A. Nuñez, M.D.
(General Medicine)
(Glez and Gonzalez Medical Center)
1840 W 49th ST Ste # 420
Hialeah, Fl. 33012
Phone: (305) 823-3000
Price 1st Visit: $40.00
Price Follow Up. $20.00
Esperanza A. Nuñez, M.D.
(General Medicine)
3804 NW 167th Street
Opalocka, Fl. 33054
Phone: (305) 624-2700
John Padron, M.D.
(General Practice)
(Opa Medical Center)
1865 NE 163th Street
North Miami, FL 33162
Phone: (305) 948-9958
Juan C. Romero, M.D.
(C&I Medical Center)
13903 NW 67th Ave #440
Miami Lakes, Fl. 33014
Phone: (305) 824-0880
Mara De Garcia, M.D.
(General Medicine)
(C&I Medical Center)
13903 NW 67th Ave #440
Miami Lakes, Fl 33014
Phone: (305) 824-0880
Armando Segui, M.D.
(General Medicine)
(Ambert Medical Center)
15495 Eagle Nest Ln, Suite 100
Phone: (305) 556-0021
Felix A. Rodriguez, M.D.
(American Family Health Center)
2150 W. 68th St, Suite 102
Hialeah, Fl. 33018
Phone: (305) 231-8996
Miguel A. Chamah, M.D.
(General Medicine)
1800 West 68th St, Suite 127
Hialeah, FL 33014
Phone: (305) 820-0903
Humberto Hernandez, M.D.
(General Medicine)
1435 West 49th Place, Ste 604
Hialeah, FL 33012
Phone: (305) 231-3151
Gilda de la Calle, M.D.
(General Medicine)
1435 West 49th Place Suite 400-B
Hialeah, Fl. 33012
Phone: (305) 823-5730
Odalys Frontela, M.D. F.A.C.P
(General Medicine)
801 West 48th St, Suite A
Hialeah, FL 33012
Phone: (305) 698-7172
Otneil Hernandez, DNP, ARNP.
(Felicidad Medical Center)
(Family Medicine)
4410 West. 16th Ave. # 55
Hialeah, Florida 33013
Phone (305) 824-8559
Lucky Flores, M.D.
(Elite Health & Rehabilitation)
6450 West. 21 Ct, Suite 200
Hialeah, Fl. 33016
Phone: (305) 698-0806
Conchita Jackson, M.D.
(General Medicine)
(Vida Health Centers)
881 E 2nd Ave
Hialeah, Fl. 33010
Phone: (305) 882-1100
Maray Rocher, M.D.
(General Practice)
87 E 49 ST
Hialeah, FL 33013
Phone: (786) 536-5001
Juan C. Sarol, M.D.
(General Practice)
87 E 49 ST
Hialeah, FL 33013
Phone: (786) 536-5001
Viviana Pérez, M.D.
(General Medicine)
4410 West. 16 ave Suite 26
Hialeah, Fl. 33012
Phone: (305) 822-8883
Miami - Dade
Miriam Estévez, M.D.
(General Medicine)
729 E 9 ST
Hialeah, FL 33010
Phone: (786) 518-3068
Price 1st Visit: $ 40.00
Price Follow Up: $ 30.00
Amando Viera, M.D.
(General Medicine)
777 East 25th St. Suite 118
Hialeah, Fl. 33013
Phone: (305) 835-0438
Edgar N Escobar, M.D.
(General Medicine)
(Florida Care Health Center)
11300 NW 87th Court, Suite 141
Hialeah Gardens, Fl. 33018
Phone: (305) 364-8600
Gretell Trullenque, M.D.
(General Medicine)
(Acevedo Medical Group)
2525 NW 54th St.
Miami, Fl. 33142
Phone: (305) 633-9090
Mayre Urdaneta, M.D.
(General Practice)
8060 NW 155th Street Ste 201
Miami Lakes, Florida 33016
Phone: (305) 826-0606
Lucky Flores, M.D.
(General Practice)
5881 NW 151 St, Suite 127
Miami Lakes, FL 33014
Phone: (305) 827-0208
Hector Rodriguez, M.D.
(General Medicine)
2525 NW 54th St.
Miami, Fl. 33142
Phone: (305) 633-9090
Jorge Martinez, M.D.
(General Medicine)
(St. John Medical Center)
161 NW 29th St
Miami, FL 33127
Phone: (305) 576-0231
Juan Delgado, M.D.
(Family Medicine)
161 NW 29th St
Miami, FL 33127
Phone: (305) 576-0231
Alicia R. Mirabal, M.D.
(General Medicine)
(Clinica Venamer)
10200 NW 25th St, Suite 114
Doral, Fl. 33172
Phone: (305) 594-6505
Jose R. Martin, M.D.
(General Medicine)
(Clinica Venamer)
10200 NW 25th St. Suite 114
Doral, Fl. 33172
Phone: (305) 594-6505
Milady Fernandez, M.D.
(General Medicine)
(Clinica Venamer)
Doral, Fl. 33172
Phone: (305) 594-6505
José Gil, M.D.
(General Medicine)
(Davila Medical Center)
782 NW 42th Ave # 348
Miami, Fl. 33126
Phone: (305) 441-2760
Jesús J. Cid, M.D.
(General Medicine)
(Medical Counsulting Center)
759 NW 22 ave
Miami, Florida 33125
Phone: (305) 649-0492
Jorge L. Santander, M.D.
(Holistic Medical Institute)
Miami, Fl 33126
Phone (305) 448-8557
2nd Phone: (305) 397-7230
Baudilio Cuzco Prieto, M.D.
(General Medicine)
(Complete Medical Care)
630 NW 33th Ave
Miami, Fl. 33125
Phone: (305) 649-6378
Mario Palomino, M.D.
(General Practice)
(Private Medical Center)
10 NW 42th Ave, Suite 300
Miami, FL 33126
Phone: (305) 774-0742
Valdemir Santos, M.D.
(General Practice)
(ACN Physician Group)
7490 SW 23 ST #201
Miami, Fl. 33155
Phone: (786) 953-8221
13
Gamaliel Mattos, M.D.
(General Medicine)
4001 N.W. 97 ave #101
Doral, Fl. 33178
Phone: (305) 418-2233
Comfort Adewumi, M.D.
(General Medicine)
(7th Ave. Medical Plaza)
10071 NW 7 ave
Miami, FL 33150
Phone: (305) 403-7777
Fax: (305) 403-7700
Francisco C. Gonzalez, M.D.
J.O. Medical Center, Inc.
42 NW 27th Avenue, Suite 303
Miami, FL 33125
Phone: (305) 642-7704
14
Ciro Reyes, M.D.
(General Medicine)
7200 N.W. 7th St #207
Miami, Fl. 33126
Phone: (305) 261-7299
Mauricio Vargas, M.D.
(General Practice)
Miami, FL 33126
Phone: (305) 774-0742
Julio C. Reyes Gavilan
J.O. Medical Center, Inc.
Miami, FL 33125
Phone: (305) 642-7704
Miami - Dade
William Mazzel, M.D.
(General Medicine)
(7th Ave. Medical Plaza)
10071 NW 7 ave
Miami, FL 33150
Phone: (305) 403-7777
Jose Pena, M.D.
(General Practice)
Miami, FL 33126
Phone: (305) 774-0742
Mario R. Villoch, M.D.
(AV Medical Center)
2075 SW 27 ave Suite 101
Miami, Fl. 33145
Phone: (305) 856-6081
Pedro R. Caro, M.D.
(General Practice)
Varadero Medical Center
5850 West Flagler ST
Miami, Fl. 33144
Phone: (305) 263-9590
Fax: (305) 263-9657
Jose Valiente, M.D.
(General Practice)
(Flagler Rehabilitation Center Inc.)
4697 W Flagler ST
Miami, Fl. 33155
Phone: (305) 461-0799
Fax: (305) 461-0775
Roberto A. Fernandez, M.D.
Latin Foundation for Health
8260 West Flagler St. Suite 2-M
Miami, Fl. 33147
Phone: (305) 228-1919
Fax (305) 228-1940
Julian Guerrero, M.D.
(General Practice)
8370 W. Flagler St, Suite 120
Miami, FL 33144
Phone: (305) 222-8365
John A. Padron, M.D.
(General Practice)
8370 W. Flagler St, Suite 120
Miami, FL 33144
Phone: (305) 222-8365
Jorge L. Santander, M.D.
(General Practice)
6621 SW 8 ST
Miami, FL 33144
Phone: (305) 262-4801
Aurelio A. Ortiz, M.D.
(General Practice)
1313 SW 1th Street.
Miami, Fl. 33135
Phone: (305) 541-8448
Hugo Romeu, M.D.
(General Practice)
(ABC Medical Group)
1393 SW 1th ST Suite 320
Miami, Fl. 33135
Phone: (305) 644-0977
Gilda de la Calle, M.D.
(General Practice)
421 SW 107th Avenue
Miami, Fl. 33174
Phone: (786) 360-4219
Fax: (786) 360-4217
Miami - Dade
Oscar Mendez Turino, M.D.
Isabel K. Yague, M.D.
(General Practice)
1393 SW 1st street # 415
Miami Florida 33135
Phone: (786) 953-6735
Abdón S. Borges, M.D.
(General Practice)
8300 SW 8th St. Suite 105
Miami, Fl. 33144
Phone: (305) 446-8236
Fax: (305) 448-7830
Alberto Gonzalez-Gomez, M.D.
(General Practice)
7968 SW 8th ST
Miami, Fl. 33144
Phone: (786) 332-2093
Adolfo R. Martínez, M.D.
(General Medicine)
8480 SW 8th Street.
Miami, Fl. 33144
Phone: (305) 264-1131
Fax:(305) 264-1134
Rogelio O. Bardiñas, M.D.
(General Medicine)
747 Ponce de Leon Blv # 700
Coral Gables, Fl. 33134
Phone: (305) 441-9700
Ines Rodriguez, ARNP
(General Medicine)
(The Wellnes Clinic Center)
15190 SW 136 ST, Suite 15
Miami, FL 33196
Phone: (305) 964-7689
Fax: 305-964-7989
Josefina Hernández, M.D.
(General Medicine)
8480 SW 8th Street.
Miami, Fl. 33144
Phone: (305) 264-1131
Fax:(305) 264-1134
Hilda M Brito M.D.
(General Medicine)
12260 SW 8th Street, Suite 224
Miami, Fl. 33184
Phone: (305) 220-6917
Julio C. Rosales, M.D.
(Hammocks Medical Center)
15122 SW 72th Street
Miami, FL 33193
Phone: (305) 383-3848
Juan Blemil Fdez. M.D, P.A.
(General Medicine)
13303 SW 42th Street
Miami, FL 33175
Phone: (305) 227-6497
Rodolfo Vega, M.D.
(General Practice)
(Vega Medical Center)
3720 SW 107 ave
Miami, FL 33165
Phone: (305) 554-4270
Antonio Blanco, M.D.
(General Medicine)
9835 SW 72th St. Suite 212
Miami, FL 33173
Phone: (305) 279-3955
Carlos E. Aguilar, M.D.
(General Medicine)
(Panamerican Sports Medicine
Institute of miami)
3850 SW 87 ave Ste 201
Miami, Fl. 33165
Phone: (305) 227-3350
Francisco Gonzalez, M.D.
(General Medicine)
(Panamerican Sports Medicine
Institute of miami)
3850 SW 87 ave Ste 201
Miami, Fl. 33165
Phone: (305) 227-3350
Eduardo Almaguer, M.D.
(General Medicine)
330 S.W 27th Ave # 404
Miami, Fl. 33135
Phone: (305) 644-9798
Julio C. Rosales, M.D.
(General medicine)
Kendall Medical Plaza
11880 SW 40 St # 120
Miami, FL 33175
Phone: (305) 225-7330
Fax: 305-225-7314
Florence Faucauld, M.D.
(General Medicine)
11010 SW 88th Street, Ste 104
Miami, FL 33176
Phone: (305) 595-1122
Jorge Santander, M.D.
(General Medicine)
26799 S. Dixie Hwy.
Naranja, Fl. 33032
Phone: (305) 258-6070
15
Rolando Padro, M.D.
(General Medicine)
15439 SW 137th Avenue
Miami, FL 33177
Phone: (305) 259-5570
Aaron B. Tuckler, M.D.
(General Medicine)
26799 S. Dixie Hwy
Naranja, Fl. 33032
Phone: (305) 258-6070
Maria C. Cubillas, M.D.
(General Practice)
27543 S. Dixie Hwy
Homestead, Fl. 33032
Phone: (305) 246-0047
Maria Delgado, M.D.
(General Practice)
(Homestead Medical Clinic, M.D)
125 N.E 8th Street
Phone: (786) 243-1909
Eduardo Medrano, M.D.
(All Family Care Inc.)
38 Northwest 8th Street
Homestead, Florida 33030
Phone: (305) 246-0460
John G. Gutleber, M.D.
(General Practice)
139 N.E 15th Street
Phone: (305) 247-1213
Fax: (305) 247-5701
WEIGHT LOSS
PROGRAM
PROGRAMA DE
PERDIDA DE PESO
Ciro Reyes, MD.PA
(General Medicine)
7200 N.W. 7th St #207
Miami, Fl. 33126
Phone: (305) 261-7299
(1st Visit and Follow Up Prices include medicines)
(Los precios de la 1ra Visita y las consultas de
seguimiento incluyen los medicamentos)
16
Miami - Dade
Broward
Silvia Soto, M.D.
(Miramar Medical Center)
11904 Miramar Parkway
Miramar, Fl. 33025
Phone: (954) 639-7560
Oli Mendez, M.D.
Miramar, Fl. 33025
Phone: (954) 639-7560
Elsa Pichardo Matos, M.D.
(Sunset Strip Medical Center)
4269 N.W 88 ave
Sunrise, Fl. 33351
Phone: (954) 578-0200
Stacy H. Katz, M.D.
(Broward Medical Center of Davie)
255 SE 14 St Suite C-1
Ft. Lauderdale, Fl. 33316
Phone: (954) 321-9826
Eugene Gregorie, M.D.
(General Medicine)
4141 NW 5th Street, Ste 100
Plantation, Fl. 33317
Phone: (954) 486-6866
Yaneth Trujillo, M.D.
(General Medicine)
1601 North Palm Ave. Suite, 102
Pembroke Pines, Fl. 33026
Phone: (954) 436-8036
Jongairo Catano, M.D.
(General Medicine)
7300 W. Menab Rd Suite 112
Tamarac, Fl. 33321
Phone: (954) 718-3752
Controlled Substance
Call for a Schedule
Mark Leeds, D.O. PA.
(General Medicine)
3500 Hollywood Blvd
Hollywood, Fl. 33021
Phone: (954) 239-6060
Mon-Fri 9am to 5pm
Call for a Schedule
Palm Beach
Daniel Hernández, MD.
(Primary Care Physician)
2531 N. Dixie Hwy
Lakeworth, Fl. 33460
Phone: (561) 582-0330
Fax: (561) 582-0339
Gynecology & Obstetrics / Ginecología y Obstetricia
Miami - Dade
Adrian Marimon, M.D.
(Gynecologist / Ginecología)e:
(Med Care Medical Center)
7200 N.W 7th Street, Suite 150
Miami, Fl. 33126
Phone: (305) 264-6270
Esperanza A. Nuñez M.D. (OB)-(GYN)
(Glez. and Glez. Medical Center)
3804 NW 167th Street.
Opa-Locka, Fl. 33054
Phone: (305) 624-2700
Esperanza A. Nuñez M.D. (OB)-(GYN)
1840 W 49th ST Ste # 420
Hialeah, Fl. 33012
Phone: (305) 823-3000
Eduardo Lavado, M.D.
(OB-GYN)
4160 W. 16 Avenue, Ste 406
Hialeah, FL 33012
Phone: (305) 822-4561
Emilio Blanco, M.D.
(OB) - (GYN)
881 East 2nd ave
Hialeah FL 33010
Phone: (305) 882-1100
Matias Guerra M.D. (OB-GYN).
(ST. John Medical Center)
161 NW 29th Street
Miami, FL 33121
Phone: (305) 576-0231
Tomas Seville, M.D. (OB-GYN).
(Holistic Medical Center)
5040 NW 7th street Suite 300
Miami Florida 33126
Phone: (305) 448-8557 / 397-7230
Ramiro Abaunza, M.D. (GYN).
(Medical Consulting Center)
3240 NW 7th Street
Miami , Florida 33125
Phone: (305) 649-0492
Conchita Jackson, M.D.(GYN))
10 NW 42 Ave Suite 300
Miami, FL 33126
Phone: (305) 774-0742
Rolando Padro, M.D.
(OB) - (GYN)
15439 SW 137 Avenue
Miami, FL 33177
Phone: (305) 259-5570
Fernando Lora, M.D.
(Gynecologist / Ginecología)
(Vital Medical Center)
8300 W Flagler, Suite 175
Miami, FL 33144
Phone: (305) 220-0300
Gynecology / Ginecología
Jongairo Catano, M.D.
(Gynecology)
7300 W. Menab Rd Suite 112
Tamarac, Fl. 33321
Phone: (954) 718-3752
Call for a Schedule
Broward
17
Pediatrics / Pediatría
18
Miami - Dade
Miriam Estévez, M.D.
(Pediatrician / Pediatra)
729 E 9 ST
Hialeah, FL 33010
Phone: (786) 518-3068
Armando Segui, M.D.
(Ambert Medical Center)
15495 Eagle Nest Ln, Suite 100
Phone: (305) 305-556-0021
Jorge L. Alsina, M.D.
4980 W. 10 Ave. Suite, 204
Hialeah, Fl. 33012
Phone: (305) 556-4447
Armando Acevedo, M.D.
Miami, Fl. 33142
Phone: (305) 633-9090
Juan Del Sol, M.D.
161 NW 29th Street
Miami, FL 33127
Phone: (305) 576-0231
Ivette Valle, M.D.
161 NW 29th Street
Miami, FL 33127
Phone: (305) 576-0231
Eduardo Díaz, M.D.
5703 NW 7 ST
Miami, Fl. 33126
Phone: (305) 267-3462
Hilda M. Brito, M.D.
Miami, Fl. 33184
Phone: (305) 220-6917
Gloria López, M.D.
747 Ponce de Leon Blv, Ste 607
Coral Gables, Fl. 31334
Phone: (305) 443-2324
Otneil Hernandez, DNP, ARNP.
(Pediatrician/Pediatra)
4410 West. 16th Ave. # 55
Phone (305) 824-8559
Rodolfo Sidron, M.D.
7285 W Flagler St
Miami, Fl. 33144
Phone: (786) 388-9877
Pedro C. Reimon, M.D.
(Child Obesity Specialist)
13155 SW 42nd Street Ste 106
Miami Florida 33175
Phone: (305) 220-1310
Maria I. Delgado, M.D.
7815 SW 24th street, Suite 106
Miami, Fl. 33155
Phone: (305) 262-2467
Rodolfo B. Ferretti M.D.
7765 SW 87 Avenue Suite 209
Miami, Fl. 33173
Phone: (305) 595-0429
Francisco Martinez, M.D.
15122 SW 72th ST
Miami, Fl. 33193
Phone: (305) 383-3848
Juan Ruiz, M.D.
(Pediatrician / Pediatría)
8900 SW 24 ST #204
Miami, Fl. 33165
Phone: (305) 554-6666
Dorses Goosby, M.D.
(Pediatric Ass. of Florida)
151 N.W 11th St. Ste E-202
Phone: (305) 245-3220
Alfredo Machado, M.D.
(Pediatric Ass. of Florida)
151 N.W 11th St. Ste E-202
Phone: (305) 245-3220
Milady Fernandez, M.D.
(All Family Care Inc.)
38 Northwest 8 Street
Phone: (305) 246-0460
Miami - Dade
Marta Delgado, M.D.
(Homestead Medical Clinic PA)
125 NE 8th St # 6
Phone: (786) 243-1909
Antonio Wong, MD
(7 years and up)
(Doctors Plus Medical Center)
501 NW 179 Avenue
Phone: (954) 442-2828
Broward
Juan F. Arteaga, MD
(7 years and up)
501 NW 179 Avenue
Phone: (954) 442-2828
Meeta Govindarajan, MD
(7 years and up)
501 NW 179 Avenue
Phone: (954) 442-2828
Yuelice Villamar, M.D.
(Sacred Hearth Medical)
(Pediatric)
17901 N.W. 5 St. # 205
Phone: (954) 392-0333
Collier
Héctor Cordero, M.D.
1090 6th Ave N
Naples, Fl. 34102
Phone: (239) 213-9200
Palm Beach
Bradley J. Bradford, M.D.
(Pediatrics by the Sea)
285 SE 5th Ave
Delray Beach, FL 3483
Phone: (561) 272-8991
Fax: (561) 272-8985
19
20
MEDICAL CENTERS / CENTROS MEDICOS
MED PLAN
CLINIC
7200 N.W 7Th Street, Suite 202
Miami, Fl. 33126
305-267-7784
A Clinic For Our
MED PLAN MEMBERS
UNA CLINICA PARA NUESTROS MIEMBROS
Med/Plan members will receive
excellent health services
aimed at detecting and preventing
diseases by means of
PREVENTIVE
MEDICINE
Nuestros miembros cuentan
con excelentes servicios de
salud especialmente pensados
para detectar y prevenir a tiempo
enfermedades mediante la
MEDICINA PREVENTIVA
21
Medical Centers / Centros médicos
Felicidad Medical Center
(Medical Center Family)
4410 West. 16th Ave. # 55
Phone (305) 824-8559
Services / Servicios:
General Medicine, Ultrasound
Laboratory, Physical Therapy
Vida Health Medical Center.
881 East 2 ave
Hialeah, Fl. 33010
Phone: (305) 882-1100
General Medicine, Surgery,
Angiology, Gastroenterology,
Gynecology and Psychiatry
Miami Community Health Center
2324 SW 8 ST
Miami, Fl. 33135
Phone: (305) 643-0535
(305) 767-5635
Fax: (305) 642-9360
General Medicine, Basic Ginecology
Psychologist, Psychiatry, Podiatry.
Complete Medical Care.
630 NW 33 Avenue
Miami, FL 33125
Phone: (305) 649-6378
General Medicine
Florida Care Health Center.
11300 NW 87th Court, Ste 141
Hialeah Gardens, Fl. 33018
Phone: (305) 364-8600
Fax: (305) 364-8604
General Medicine
Medical Counsulting Center.
3240 NW 7th Street
Miami , Florida 33125
Phone: (305) 649-0492
General Medicine, .Ginecology
Physicial Therapy
C&I Medical Center.
13903 NW 67th Ave #440
Phone: (305) 824-0880
General Medicine
Gonzalez and Gonzalez.
Opa-Locka Fl. 33054
Phone: (305) 624-2700
Fax: (305) 624-3154
General Medicine, Psychiatrist
Psiquiatry, Gynecology
Private Medical Center.
10 NW 42th Ave. Suite 300
Miami, Fl. 33126
Phone: (305) 774-0742
General Medicine, Ginecology
Pediatric, Cardiology
Acevedo Medical Group.
2525 NW 54th Street
Miami, Fl. 33142
Phone: (305) 633-9090
Fax: (305) 633-9383
General Medicine
Ambert Medical Center.
15495 Eagle Nest Ln Suite 100
Phone: (305) 556-0021
General Medicine
Pediactrics
St. John Clinic Medical Center.
161 NW 29th Street.
Miami, FL 33127
Phone: (305) 576-0231
General Medicine, Pediatric
Podiatric, Cardiovascular
Gynecology, Orthopedic
California Club Medical Center.
790 Ives Dary Rd.
North Miami Beach, Fl. 33179
Phone: (305) 405-0365
Internal Medicine
Opa Medical Center.
1865 NE 163th Street.
Miami, FL 33162
Phone: (305) 948-9958
General Medicine
Gynecology and Minor Surgery
J.O. Medical Center.
42 NW 27 ave Ste 303
Miami, Fl. 33125
Phone: (305) 642-7704
General Medicine
22
Miami - Dade
Miami - Dade
Holistic Medical Center
(Family Medicine)
5040 NW 7th Street, Suite 300
Miami, Fl. 33126
Phone: (305) 448-8557
General Medicine, Gynecology
Ophthalmology
Hammocks Medical Center.
15122 SW 72 Street.
Miami Florida 33193
Phone: (305) 383-3848
General Medicine
Pediactrics
Latin Foundation for Health.
8260 West Flagler Street, Suite 2-M
Miami, Fl. 33147
Phone: (305) 228-1919
Fax: (305) 228-1940
General Medicine, Alergyst
ACN Physician Group
7490 SW 23 St, Ste 201
Miami, Fl. 33155
Phone: (786) 953-8221
General Medicine
Delgado Pediatrics After Hours PA.
Miami, Fl. 33155
Phone: (305) 262-2467
Pediactric
Anchor Medical Center.
12781 SW 40th St # H
Miami, Fl. 33175
Phone: (305) 229-3990
Fax: (305) 229-3880
General Medicine
Flagler Rehabilitation Center Inc.
4697 W. Flagler Street.
Miami, Fl. 33134
Phone: (305) 461-0799
General Medicine
Physical Therapy
Universal Community Mental Care.
928 SW 82 Ave.
Miami, Fl. 33144
Phone: (305) 265-5744
Fax: (305) 265-5745
General Medicine,
Internal Medicine
Psyquiatry, Psychologist,
Neurology, Pain Management,
Podiatry
ABC Medical Group.
1393 SW 1st Street, Suite 320
Miami Florida 33135
Phone: (305) 644-0977
General Medicine,
Psychiatry, Psychology,
Physicial Therapy
Ophthalmology, Dental,
Podiatry, Optical
All Family Care Inc.
38 NW 8th Street.
Phone: (305) 246-0460
General Medicine
Pediactrics
Pediatrics Ass. of South Florida.
151 N.W 11th Street, Suite E-202
Phone: (305) 245-3220
Fax: (305) 247-5849
Pediactrics
Homestead Medical Clinic PA.
125 NE 8th Street, Suite 6
Phone: (786) 243-1909
General Medicine
Pediactrics
Broward
Emeril Health Medical Center.
4330 Sheridan Street, Suite 102
Hollywood, Fl 33021
Phone: (954) 987-4455
Fax: (954) 964-7342
Internal Medicine
Pines Care Medical Center,
LLC.
301 NW 103 Ave, # 235
Phone: (954) 251-1497
Fax: (954) 404-9537
General Medicine
Internal Medicine
Miramar Medical Center.
Miramar, Fl. 33025
Phone: (954) 639-7560
Fax: (954) 639-7563
Medicina Interna,
General Medicine, Rayos X
Cardiology, Endocrinology
Ultrasound
Sunset Strip Medical Center.
4269 N.W.88 ave
Sunrise FL 33351
Phone: (954) 578-0200
Doctor Plus Medical Center.
501 NW 179 Ave.
Phone: (954) 442-2828
Fax: (954) 442-3366
General Medicine
Internal Medicine, Pediactric
Doctor Plus Medical Center.
4204 N. State Rd. # 7
Lauderdadle Lakes, Fl. 33319
Phone: (954) 714-8780
Fax: (954) 769-1175
Internal Medicine, Pediactric
23
Broward Medical Center of Davie.
255 SE 14 St Suite C-1
Ft. Lauderdale, FL 33316
Phone: (954) 321-9826
Fax: (954) 321-9660
General Medicine
Urgent Care Center.
(UrgentMed)
2337 S. University Drive
Davie, FL 33324
Phone: 954-423-9234
Fax: (954) 423-9231
French, Italian & Creole
General Medicine
Naples Health Care Inc.
Martha R. Fernandez, M.D.
(General Medicine & Gynecology)
4947 Tamiami Trail North Suite 206
Naples FL 34103
Phone: (239) 304-9290
SERVICES / SERVICIOS:
Multi Specialist Practice,
Podiatry, Physical Therapy
Angel Garcia, D.P.M.
(Podiatry)
Naples FL 34103
Phone: (239) 304-9290
24
Broward
Del Prado Medical Center.
Martha R. Fernandez, M.D.
(General Medicine)
2500 Del Prado Blvd South
Cape Coral FL 33954
Phone: (239) 772-1194 / 1195
Multi Specialist Practice
General Medicine,
Gynecology, Podiatry
Podiatría, Physical Therapy
Nelson Gonzalez, M.D.
(Podiatry)
Cape Coral FL 33954
Phone: (239) 772-1194 / 1195
General Medicine,
Calixto Garcia, M.D.
(Psychologist)
Cape Coral FL 33954
Phone: (239) 772-1194 / 1195
General Medicine, Psychologist
The Medical Center of Lehigh Acres.
1303 Homestead Rd. North, Suite 102
Lehigh Acres, Fl. 33936
Phone: (239) 303-2700
General Medicine, Internal Medicine
Psychiatry, OB-GYN, Chiropractor
Laser Therapy, Therapeutic massage
Acupuncture and Radiology.
Collier
Calixto Garcia, M.D.
(Psychologist)
Naples FL 34103
Phone: (239) 304-9290
Lee / Cape Coral
Luis Martinez, M.D.
(Ginecology)
Cape Coral FL 33954
Phone: (239) 772-1194 / 1195
General Medicine,
SPECIALIST PHYSICIANS / ESPECIALISTAS
Angiology / Angiólogo
Miami-Dade
Abdón S. Borges, M.D.
(Angiology / Angíologo)
8300 West Flagler St. Suite 105
Miami, Fl. 33144
Phone: (305) 446-8236
Price: 1st. Visit $ 80.00
Follow Up: $ 50.00
Alergist /Alergista
Roberto A. Fernandez, M.D.
(Latin Foundation for Health)
8260 West Flagler Street, Suite 2-M
Miami, Fl. 33144
Phone: (305) 228-1919
Follow Up: $ 40.00
Miami-Dade
Vicente A. Chavarria, M.D
(Alergist / Alergista)
1840 W. 49th Street, Suite 515
Hialeah, Fl. 33012
Phone: (305) 670-7006
Follow Up: $ 50.00
Anesthesiology / Anestesiólogo
Lazaro R. Martinez, M.D.
(Pain Management)
(Universal Comunity Mental Care)
928 SW 82 Ave.
Miami, Fl. 33144
Phone: (305) 265-5744
Follow Up: $ 40.00
Vicente A. Chavarria, M.D
(Alergist / Alergista)
7400 N. Kendall Dr., Suite 204
Miami, Fl. 33156
Phone: (305) 670-7006
Follow Up: $ 50.00
Miami-Dade
Manuel A. Barbeito, M.D.
(Pain Management)
(South Florida Institute of Pain
Management)
9370 Sunset Dr. Suite A-150
Miami, Fl. 33173
Phone: (305) 663-6681
Follow Up: $ 40.00
Cardiology / Cardiólogo
Miami-Dade
(Cardiologist / Cardiólogo)
(AV Medical Center)
2075 SW 27 ave #101
Miami, Fl. 33145
Phone: (305) 856-6081
Follow Up: $ 40.00
Francisco Dieguez, M.D.
1435 West 49 Place, Suite 500
Hialeah, FL 33012
Phone: (305) 575-1776
Fax: (305) 575-1780
Follow Up: $ 40.00
10 NW 42 Ave Suite 300
Miami, FL 33126
Phone: (305) 774-0742
Follow Up: $ 40.00
Guido A. Perez, MD
(Cardiovascular Disease)
8756 SW 8 St,
Miami, Fl 33174
(Phone: (305) 554-1819
Michelle Malow, M.D.
161 NW 29 Street.
Miami, FL 33127
Phone: (305) 576-0231
Follow Up: $ 40.00
25
Cardiology / Cardiología
Mian Hasan, MD
(Cardiology / Cardiología)
603 N Flamingo Road #150
Pembroke Pine, Fl 33028
(Phone: (954) 436-6660
Broward
Shravan Ambati, MD
(Cardiology / Cardiología)
603 N Flamingo Road #150
Pembroke Pine, Fl 33028
Phone: (954) 436-6660
Chiropractor / Quiropráctico
Aixa Goodrich, D.C.
(Chiropractic)
7990 SW 117 Ave Suite 205
Miami, FL 33183
Phone: (305) 271-7447
Fax: (305) 271-7448
Miami - Dade
Maria Del Campillo, DC.
(Chiropractor)
3625 NW 82nd Ave. Suite 320
Doral Florida 33166
Phone: (305) 593-1555
Fax: (305) 593-1556
Chiropractor / Quiropráctico
Dennis Kogut, DC.
(Chiropractor)
9999 NE 2nd ave Ste # 303
Miami Shores, FL 33138
Phone: (305) 978-7680
Fax: (305) 757-6220
Broward
Jan Scott Buchholz, D.C.
(Chiropractor)
(Hands On Healthcare)
2901 West Oakland Park Blvd, Suite A-23
Ft. Lauderdale, FL 33311
Phone: (954) 731-8097
Cosmetic Surgery / Cirugía Cosmética
Constantine N. Kitsos, M.D.
(Board certified plastic surgeon)
(Seduction Cosmetic Center)
2500 NW 107 Ave #102
Doral, Fl. 33172
Phone: (305) 406-9055
(See price list, Pag.36/37)
Camille Chavez, M.D.
2500 NW 107 Ave #102
Doral, Fl. 33172
Phone: (305) 406-9055
Patrick Abuzeni, M.D.
2500 NW 107 Ave #102
Doral, Fl. 33172
Phone: (305) 406-9055
Manuel Lopez Prieto, M.D.
2500 NW 107 Ave #102
Doral, Fl. 33172
Phone: (305) 406-9055
Miami - Dade
Horacio Leyva, M.D.
(Board Certified Plastic Surgeon)
2500 NW 107 Ave #102
Doral, Fl. 33172
Phone: (305) 406-9055
As a provider of Med Plan, Seduction Cosmetic Center will like to offer all MedPlan clients as of August 10, 2011 the Lap Band System at a promotional price of $8,500.00. This offer is only valid till December 31,2012.
Como proveedor de Med Plan, Seduction Cosmetic Center se complace en ofrecer a todos los miembros de Med Plan, a partir del
10 de Agosto de 2011, el sistema de banda gástrica por un precio promocional de $8,500.00. Esta oferta estará disponible solamente
hasta el 31 de Diciembre de 2012.
26
Dermatology / Dermatología
Miami - Dade
Jaime Garcia, M.D.
(Dermatology)
935 West 49 St #107
Hialeah, FL 33012
Phone: (305) 827-2268
Hector Wiltz, M.D.
(Eric W. Bussear M.P.H, PA-C)
(Dermatology)
151 NW 11 Street, Suite W-201
Homestead Florida 33030
Phone: (305) 245-1332
Maria Cartaya, M.D.
(Dermatology)
7805 Coral Way, Suite 131
Miami, Fl. 33175
Phone: (305) 261-4474
Hector Wiltz, M.D.
(Dermatology)
11760 SW 40th Street Ste 451
Miami Florida 33175
Phone: (305) 227-9233
Endocrinology / Endocrinología
Carlos Barrera, M.D.
(Endocrinology)
7400 North Kendall Dr., Suite 617
Miami, Fl. 33156
Phone: (305) 670-0576
Hector Wiltz, M.D.
(Eric W. Bussear M.P.H , PA-C)
(Dermatology)
7400 N. Kendall Drive Suite 411
Miami Florida 33156
Phone: (305) 670-0178
Miami - Dade
Carlos Barrera, M.D.
(Endocrinology)
151 NW 11th Street, Ste 102-B
Phone: (305) 670-0576
Endocrinology / Endocrinología
Broward
Emilio Castañeda
Miramar, Fl. 33025
Phone: (954) 639-7560
E.N.T. / Otorrino
Miriam Lacayo, M.D.
(E.N.T. / Otorrino)
7821 Coral Way Suite 104
Miami FL 33155
Phone: (305) 261-1337
Fax: (305) 261-1997
Miami - Dade
Maria T. llopiz, M.D.
(E.N.T. / Otorrino)
330 SW 27 ave Suite 603
Miami FL 33155
Phone: (305) 649-5455
27
Gastroenterology / Gastroenterólogo
Orlando Torres, M.D.
(Gastroenterology)
360 West 49th Street.
Hialeah, Fl. 33012
Phone: (305) 825-0500
Fax: (305) 825-5557
Servicios: All Included
Endoscopía $ 530.00
Colonoscopía $ 675.00
Sigmoidoscopía $ 400.00
Juan Sarol, M.D.
(Gastroenterology)
881 E 2nd ave
Hialeah, FL 33010
Phone: (305) 882-1100
Internal Medicine / Medicina Interna
Miami - Dade
Felix A. Rodriguez, M.D.
(Internal Medicine)
(American Family Health Center)
2150 W. 68th Street, Suite 102
Hialeah, Fl. 33018
Phone: (305) 231-8996
Fax: (305) 231-8433
Noel E. Lezama, M.D.
(Internal Medicine)
(Universal Comunity Mental Care)
928 SW 82 Ave.
Miami, Fl. 33144
Phone: (305) 265-5744
Fax: (305) 265-5745
Juana Gutierrez, M.D.
(Internal Medicine)
(California Club Medical Center)
790 Ives Dairy Rd., O.P.
Phone: (305) 405-0365
Fax: (305) 405-0370
Mayre Urdaneta, M.D.
(Internal Medicine)
8060 NW 155th Street Ste 201
Miami Lakes, Florida 33016
Phone: (305) 826-0606
Fax: (305) 826-0630
(General Medicine)
1435 West 49th Place, Ste 604
Hialeah, FL 33012
Phone: (305) 231-3151
Renato Dominguez, M.D.
(Internal Medicine)
85 Gran Canal Dr. Suite 209
Miami, Fl. 33144
Phone: (305) 263-8340
Alejandro de la Cruz, M.D.
(Internal Medicine)
4118 W 12 Ave
Hialeah, Fl. 33012
Phone: (305) 824-8787
Odalys Frontela, M.D. F.F.C.P
(General Medicine)
801 West 48th Street, Suite A
Hialeah, FL33012
Phone: (305) 698-7172
Joseph Thevenin, M.D.
(Internal Medicine)
9635 SW 181 Terrace.
Miami, Fl. 33157
Phone: (305) 238-8561
José Padrón, M.D.
(Internal Medicine)
2601 SW 37 Ave, Suite 707
Miami, Fl. 33133
Phone: (305) 569-0010
(Internal Medicine)
(AV Medical Center)
2075 SW 27 ave #101
Miami, Fl. 33145
Phone: (305) 856-6081
Follow Up: $ 40.00
Manuel Jimenez Rodriguez M.D.
(Internal Medicine)
The Wellness Clinic Center
15190 SW 136 ST, Suite 15
Miami, Fl. 33196
Phone: (305) 964-7689
Ramses Vega, M.D.
(Internal Medicine)
3720 SW 107 ave
Miami, Fl. 33165
Phone: (305) 554-4270
Follow Up: $ 40.00
28
Miami - Dade
Internal Medicine / Medicina Interna
Broward
Herbert Pardell, DO.
(Emeril Health Medical Center)
4330 Sheridan Street, Suite 102
Hollywood, Fl 33021
Phone: (954) 987-4455
Antonio Wong, M.D.
4204 N State Road 7
Lauderdale Lakes, Fl. 33319
Phone: (954) 714-8780
Emilio Castañeda, M.D.
Miramar, Fl. 33025
Phone: (954) 639-7560
Antonio Wong, M.D.
501 NW 179 Avenue
Phone; (954) 442-2828
Santiago Cardenas ,M.D.
Pines Care Medical Center, LLC
(General & Internal Medicine)
301 NW 103 Ave, # 235
Phone: (954) 251-1497
Juan F. Arteaga, M.D.
501 NW 179 Avenue
Phone: (954) 442-2828
Karen Prida, M.D.
301 NW 103 Ave, # 235
Phone: (954) 251-1497
Jayner Moya, M.D.
301 NW 103 Ave, # 235
Phone: (954) 251-1497
Meeta Govindarajan, M.D.
501 NW 179 Avenue
Phone: (954) 442-2828
Nephrology / Nefrología
Federico Dumenigo, M.D.
(Nephrology / Nefrólogo)
78 SW 13 Ave #201
Miami, Fl. 33135
Phone: (305) 631-0470
Fax: (305) 631-9962
Miami - Dade
Guibel Perera, M.D.
(Nephrology / Nefrólogo)
10710 SW 38 ST
Miami, Fl. 33165
Phone: (305) 392-1000
Fax: (786) 332-4357
Neurology / Neurología
Miami - Dade
James Gorelick, M.D.
(Neurology / Neurología)
351 NW Le Jeune Rd Suite 103
Miami FL 33126
Phone: (305) 642-4616
Fax: (305) 631-1419
Carlos Perez, M.D.
(All Future Medical Center)
3237 NW 7 Th Street, Suite 101
Miami, Fl. 33125
Phone: (305) 805-6903
(305) 879-1753
Martha Bustamante, M.D
(Pediatric Neurology)
4160 W. 16 Ave. Suite 100
Hialeah, Fl. 33012
Phone: (305) 826-5655
Price 1st Visit: $ 80.00 **
Price Follow Up: $ 50.00 **
Lisette Nogues, M.D
(Neurology)
8525 S.W. 92th ST
Miami, Fl. 33156
Phone: (305) 412-4545
Price 1st Visit: $ 80.00 **
Price Follow Up: $ 50.00 **
James Gorelick, M.D.
20700 West Dixie Hwy
Adventura FL 33180
Phone: (305) 642-4616
Fax: (305) 631-1419
29
Diagnostic Center of Neurological Studies
Miami - Dade
Neurology Mobile System Associates, Inc
7374 SW 93 ave, Suite 201
Miami, FL 33173
Phone: 305-270-7771
Fax: 305-270-7775
PROCEDURE
Soft-Tissue
Ultrasound
DESCRIPTION
Cervical Soft Tissue
Spinal Canal & Contents
Extremities Leg / Arm
Neurological NCS Upper Motor
Studies
NCS Upper Motor + F-Wave
NCS Upper Sensory
NCS Lower Motor
NCS Lower Motor + F-Wave
NCS Lower Senory
EEG - Electroencephalogram
BAER - Brainstem Auditory Evoked Response
VER - Visual Evoked Response
VEP - Visual Evoked Potential
EMG - 1 Extremity
EMG - 2 Extremities
EMG - 3 Extremities
EMG - 4 Extremities
Orbucularis Ocull - Blink
Cardiac Studies Echo 2D M-Mode
Cardiac Doppler
Coloflow Doppler
EKG Holter
Electrocardiogram
Holter Monitor 24 hour (Global)
Vascular Studies Carotid Arterial Doppler
Carotid Arterial Duplex
Arterial Doppler (Bilateral)
Arterial Duplex (Bilateral)
Arterial Duplex (Unilateral)
Venous Doppler (Bilateral)
Venous Doppler (Bilateral)
Venous Duplex (Unilateral)
Small Parts
Testicular
Breast
Thyroid
Biophysical
Pelvic Complete
Bladder
Obstetric Complete
Abdominal
Abdominal Complete (2 or More)
Studies
Abdominal Limited (Only 1 organ)
Retro Complete (2 or More)
Retro Limited (Only one organ)
30
CPT
CODES
76536
76800
76880
95900
95903
95904
95900
95903
95904
95819
92585
92280
95930
95860
95861
95863
95864
95933
93307
93320
93325
93000
93230
93875
93880
93923
93925
93926
93965
93970
93971
76870
76645
76536
76856
76857
76805
76700
76705
76770
76775
Member
Fees
$100.00
$100.00
$100.00
$125.00
$125.00
$125.00
$125.00
$125.00
$125.00
$150.00
$125.00
$125.00
$125.00
$130.00
$180.00
$225.00
$275.00
$150.00
$150.00
$150.00
$100.00
$100.00
$90.00
$90.00
$100.00
$100.00
$100.00
$90.00
$90.00
$75.00
$75.00
$75.00
$70.00
$70.00
$70.00
$70.00
$70.00
$70.00
$70.00
Ophthalmology / Oftalmología
Miami - Dade
Manuel Airala, M.D.
Marta Airala M.D.
(Laser & Cataract Institute)
202 East 49 Street.
Hialeah, FL 33013
Phone: (305) 558-7895
Osvaldo Caffa, M.D.
202 East 49 Street.
Hialeah, FL 33013
Phone: (305) 558-7895
Jonathan Leon-Rosen, M.D.
202 East 49 Street.
Hialeah, FL 33013
Phone: (305) 558-7895
Tomas Ugarte M.D.
(Ophthalmology)
900 West 49th Street, Ste 300
Hialeah, Fl. 33012
Phone: (305) 823-6525
Fax: (305) 823-6527
Alejandro Estaillat, M.D.
(Ophthalmology / Oftalmología)
(Holistic Medical Center)
5040 NW 7th street Suite 300
Miami Florida 33126
Phone: (305) 397-7230
Marta Airala, M.D.
2441 SW 37 Avenue.
Miami, FL 33145
Phone: (305) 442-0066
Jonathan Leon-Rosen MD
2441 SW 37 Avenue.
Miami, FL 33145
Phone: (305) 442-0066
Osvaldo Caffa MD
2441 SW 37 Avenue.
Miami, FL 33145
Phone: (305) 442-0066
Manuel Airala, M.D.
2441 SW 37 Avenue.
Miami, FL 33145
Phone: (305) 442-0066
Orthopedics / Ortopedia
Miami - Dade
Alejandro de la Cruz, M.D.
(Orthopedic / Ortopédico)
4118 W 12 Ave
Hialeah, Fl. 33012
Phone: (305) 824-8787
Carlos Roig, M.D.
(Orthopedic Medicine & Surgery)
161 NW 29 Street,
Miami, FL 33127
Phone: (305) 576-0231
Gustavo Torres, M.D.
900 West 49th Street, Suite 450
Hialeah, Fl. 33012
Phone: (305) 821-4020
Ignacio Calvo, M.D.
777 East 25 Street, Suite 508
Hialeah, FL 33013
Phone: (305) 696-7772
Arnaldo V. Lopez, M.D.
1545 S.W 1St Street, Suite 200
Miami, Fl. 33135
Phone: (305) 541-3230
Fax: (305) 541-1650
Jose L Ponce de Leon, M.D.
(Orthopedic / Ortopédico)
9746 Coral Way.
Miami, Fl. 33165
Phone: (305) 229-1227
Ignacio Calvo, M.D.
1800 SW 27 Ave, Ste 400
Miami, FL 33145
Phone: (305) 856-7411
31
Podiatry / Podiatría
Miami - Dade
Hialeah Foot Center.
(Podiatry / Podiatría)
4410 West 16 Ave #53
Hialeah, Fl. 33012
Phone: (305) 558-7437
Nguyen Phu, D.P.M.
3661 S. Miami Ave. Suite 309
Miami, Fl. 33133
Phone: (305) 854-6600
Yanssel Delgado, D.P.M.
1490 West 49th Place #590
Miami, Fl. 33012
Phone: (305) 819-9240
Richard Mallia, D.P.M.
161 NW 29 Street.
Miami, FL 33127
Phone: (305) 576-0231
Joaquin Fernandez, D.P.M.
605 SW 57 Avenue.
Miami, FL 33144
Phone: (305) 269-8223
Fax: (305) 262-0554
Oscar Barreto, D.P.M.
(D.P.M., F.A.C.F.A.S).
7975 NW 154th Street, Ste 390
Phone: (305) 825-5633
Francisco Perez, C.M.D.
(Elite Health & Rehabilitation)
6450 W. 21th Ct Suite 200
Hialeah, Fl. 33016
Phone: (305) 698-0806
Juliette Perez, D.P.M.
(Perfect Feet Care Podiatry Center)
13651 SW 26th Street.
Miami, Fl. 33175
Phone: (305) 225-4277
Edward Gonzalez, D.P.M.
(Universal Community Mental Care)
928 S.W. 82 ave
Miami, Fl. 33144
Phone: (305) 265-5744
Flavia Inesta, D.P.M.
1797 SW 3 ave
Miami, Fl. 33129
Phone: (305) 856-4454
Richard Santo, D.P.M.
2324 SW 8 ST
Miami, Fl. 33135
Phone: (305) 643-0535
Podiatry / Podiatría
Broward
Dominique Rameau, D.P.M.
2261 N. University Dr. # 201
Phone: (754) 263-2522
Fax: (754) 263-2526
Psychiatry / Psiquiatría
José C. López, M.D.
(Psychiatry / Psiquiatría)
Opa-Locka, Fl. 33054
Phone: (305) 624-2700
32
Miami - Dade
Evelyn Lopez Brignom, M.D.
(Adults and Children )
Miami Community Health Center
2324 SW 8 ST
Miami, Fl. 33135
Phone: (305) 643-0535
(305) 767-5635
Fax: (305) 642-9360
Camilo Pérez, M.D.
881 E 2nd ave
Hialeah, FL 33010
Phone: (305) 882-1100
Psychiatry / Psiquiatría
Carlos Perez, M.D.
(All Future Medical Center)
Miami Florida 33125
Phone: (305) 805-6903
(305) 879-1753
Miami - Dade
Carlos J. Sandoval, M.D.
José C. López, M.D.
(Universal Community Mental care)
928 SW 82 Ave.
Miami, Fl. 33144
Phone: (305) 265-5744
Daniel Mandri, M.D.
151 NW 11th Street, Suite E-304
Phone: (305) 457-9333
Fax: (305) 245-0375
Daniel Mandri, M.D.
9621 SW 40th Street.
Miami Florida 33165
Phone: (305) 418-0841
Fax: (305) 418-0849
Psychology / Psicología
Miami - Dade
Mercedes Llenin, M.D.
(Psychologist / Psicológo)
5600 SW 135 Ave, Suite 116
Miami, Fl. 33183
Phone: (305) 387-7850
Psychology / Psicología
Broward
Maria Moncayo, M.D.
(Psychologist / Psicológo)
10406 Taft St
Pembroke Pines, Fl 33138
Phone: (954) 436-3880
Pulmonology / Neumología
Miami - Dade
(Pulmonary Medicine)
1435 West 49n Place #604
Hialeah, FL 33012
Phone: (305) 231-3151
Fax: (305) 885-5884
33
Rheumatology / Reumatología
Carlos A. Sesin, M.D.
Vanguard Rheumatology Partners
(Rheumtatology)
Mount Sinai Medical Center
4302 alton Rd # 810
Miami Beach, FL 33140
Phone: (305) 531-6766
Fax: (305) 531-6712
Ricardo Garcia - Alemany, M.D.
Vanguard Rheumatology Partners
(Rheumtatology)
Mount Sinai Medical Center
4302 alton Rd # 810
Miami Beach, FL 33140
Phone: (305) 531-6766
Fax: (305) 531-6712
Surgery / Cirugía
(Surgeon / Cirujano)
(Private Medical Center Inc).
10 NW 42nd street Ste 300
Miami Florida 33126
Phone:(305) 774-0742
Fee: Florida Medicaid Rate
Miami - Dade
Miami - Dade
John Padron, M.D.
(OPA Medical Center)
1865 NE 163 Street
Miami, FL 33162
Phone: (305) 948-9958
Jorge Alvarez Moreno, M.D.
881 E 2nd ave
Hialeah, FL 33010
Phone: (305) 882-1100
Fernando Lora, M.D.
(Surgeon / Cirujano General y Vascular)
(Vital Medical Center)
8300 W Flagler, Suite 175
Miami, FL 33144
Phone: (305) 220-0300
Urology / Urología
Luis Sabogal, M.D.
(Urology / Urología)
1800 SW 27 Avenue, Suite 402
Miami, FL 33145
Phone: (305) 445-2404
Luis F. Maggiolo, M.D.
(Urlogy / Urología)
747 Ponce de Leon Blvd # 502
Coral Gables, FL 33134
Phone: (305) 444-2858
Fax: 305-448-3346
34
Miami - Dade
Juan B Suarez, M.D.
5450 SW 8th St #204
Miami, FL 33134
Phone: (305) 443-8041
Fax: (305) 444-2054
Eduardo Guzman, M.D.
1800 SW 27 Avenue, Ste 402
Miami, FL 33145
Phone: (305) 445-2404
URGENT CARE CENTERS
At Med Plans contracted Urgent Care Centers, you’ll find experienced professionals who firmly believe everyone deserves
access to affordable medical care.
If you or a family member is experiencing life-threatening illness or injury-such as major head trauma, chest pain, severe
abdominal pain, or loss of consciousness – you should go directly to an Emergency Room (ER). See the list below for
guidance on what situations require ER treatment.
• Falls from greater than 7 feet
• Loss of consciousness
• Infants less than 6 months of age or with a temperature greater than 103 degrees
• Pregnancy bleeding or complications
• Life-threatening allergic reactions
• Severe burns
• Severe choking (cannot breathe or talk)
• Severe abdominal pain
• Signs or symptoms of stroke or heart attack
• Amputation of a body part
• Near drowning
• Electrical shock
• Open or angulated fractures
CENTROS DE URGENCIAS
Med Plan tiene contratados “Centros de Cuidado de Urgencias” donde usted encontrará un servicio rápido, económico y
eficiente ofrecido por profesionales experimentados que creen firmemente que todos merecen tener acceso a la atención
médica.
Si usted o algún miembro de la familia está sufriendo una enfermedad potencialmente mortal o lesiones - como: Traumatismos
craneales importantes, Dolor torácico, Dolor abdominal intenso o pérdida de la conciencia debe ir directamente a una
sala de emergencias (ER). Vea la lista a continuación para obtener orientación sobre las situaciones que requieren un
tratamiento (ER).
• Caídas de más de 7pies de altura.
• Pérdida de conciencia.
• Los bebés menores de seis meses de edad o con una temperatura superior a 103 grados.
• Sangrado o complicaciones de embarazo.
• Reacciones alérgicas que puedan poner en peligro la vida
• Quemaduras graves
• Asfixia severa que le impide respirar o hablar
• Dolor abdominal severo
• Signos o síntomas de derrame cerebral o ataque al corazón
• Pérdida o desmembramiento de una parte del cuerpo
• Si usted está a punto de ahogarse
• Una descarga eléctrica
• Fracturas abiertas o anguladas
Urgent Care Centers / Centros de Urgencia
Miami - Dade
Med Clinic Inc.
9588 NW 41th St.
Miami Florida 33178
Phone: (305) 477-4475
Fax: (305) 477-4487
Language: English / Spanish
Elite Health & Rehabilitation.
6450 W. 21 Ct. Suite 200
Hialeah, Fl. 33016
Phone: (305) 698-0806
Fax: (305) 698-2325
Clinica Venamer.
(Urgent Care)
Doral, Fl. 33172
Phone: (305) 594-6505
Fax: (305) 594-6591
HOURS OF OPERATION:
MON – FRI 10AM – 10:00PM
SAT – SUN 10:00AM – 10:00PM
HOURS OF OPERATION:
MON – FRI 8:AM – 6:00PM
SAT – 8:00AM – 2:00PM
HOURS OF OPERATION:
MON – FRI 8:00AM – 10:00PM
SAT 8:00AM – 12:00PM
35
Private Medical Center.
(Urgent Care)
10 NW 42th Ave. Suite 300
Miami, Fl. 33126
Phone: (305) 774-0742
HOURS OF OPERATION:
MON – FRI 8:00AM – 10:00PM
SAT 8:00AM – 12:00PM
MDD Medical Center.
(Urgent Care)
6905 NW 77 ave
Miami, Fl. 33166
Phone: (305) 884-1919
Fax: (305) 884-1969
HOURS OF OPERATION:
MON – FRI 10:00AM – 6:00PM
Miami - Dade
Campbell Urgent Care.
1855 NE 8th Street.
Phone: (305) 242-8025
Fax: (305) 245-1839
HOURS OF OPERATION:
MON – FRI 8:00AM – 8:00PM
SAT – SUN 10:00AM – 4:00PM
Broward
Urgent Care Center.
(UrgentMed)
2337 S. University Drive
Davie, FL 33324
Phone: 954-423-9234
Fax: (954) 423-9231
Medicaid Rates after 5:00 PM.
HOURS OF OPERATION:
MON – FRI 9:00AM – 9:30PM
SAT – 9:00AM – 5:00PM
URGENT CARE TIER PRICING
Tier One (Basic Visit) includes:
$60.00
• Any and all levels of service, including initial visits and established patient visits.
• Instant test(s) performed at the center.
- Urine dip.
- Instant strep
- Mono
- Flu
- Pregnancy
- Hemoccult
- Glucose
- HIV
Tier Two (Intermediate Visit) includes:
$120.00
• Tier One (Basic Visit) above PLUS
- X-Rays of single body area performed in the center.
- Injection of pain meds or antibiotics.
- Vaccine administration (vaccine charged as exclusion below)
- Venipuncture or specimen collection for any lab outside reference lab (lab test
charged as exclusion below)
Tier Three (Advanced Visit) includes:
• Tier Two (Intermediate Visit) PLUS
• Single procedures performed in the center including but not limited to:
- Nebulizer treatment
- Laceration repair.
- Burn dress/debride
- Foreign body removal
- Cast / Splint application
- IV Therapy
- EKG
36
$145.00
DENTAL SERVICES / SERVICIOS DENTALES
Med Plan Dental Providers are offering exclusive pricing to all our members consisting of:
•
Simple Cleanings that include Oral Examination, X-Rays, Topical anesthesia, for only $49 (Code 1110). For persons
under the age of 16 this service is provided for $35 (Code 1120). All minors will receive topical fluoride treatment
included with their cleaning.
•
Deep cleanings are offered for $75 per quadrant (Code 4341) which include oral examination, complete x-rays,
and anesthesia. This service does not include panoramic x-rays. All minors will receive topical fluoride treatment
included with their cleaning.
IF THE CLEANING PROCEDURE REQUIRES THE USE OF ARESTIN AS PART OF THIS SERVICE, THE PATIENT WILL BE
PROVIDED AND ALTERNATIVE ORAL ANTIBIOTIC AT A LESSER EXPEND.
Los proveedores de servicios dentales asociados a MedPlan están ofreciendo precios exclusivos a nuestros
miembros. Entre los más destacados están:
•
•
Limpieza Simple que incluye Examen Oral, Rayos X, Anesthesia, todo por el precio de $49.00 para adultos (Código
1110) y $35.00 para menores de 16 años (Código 1120). En el caso de los menores de 16 años se le incluye
también la aplicación de fluoride anticarie.
Limpieza Profunda en una dentadura completa por $75.00 el cuadrante (Código 4341). Si la dentadura está
incompleta el precio a pagar será de $60.00 (Código 4342). Dicha limpieza incluye Examen Oral, Rayos X (no
panorámicos), Anesthesia. En el caso de los menores de 16 años se le incluye también la aplicación de fluoride
anticarie.
EL USO DE ANTIBIOTICO ARESTIN EN EL PROCEDIMIENTO DE LA LIMPIEZA ES DECISION PERSONAL DEL PACIENTE. EL
PACIENTE TIENE COMO ALTERNATIVA EL USO DE OTRO ANTIBIOTICO RECOMENDADO POR EL DENTISTA.
Dentistry / Odontología
Miami - Dade
Med Dental Associated Inc.
7200 NW 7St Suite 340
Miami, FL 33126
Phone:
Fax:
(Abre en en mes de Julio)
America Dental Clinic
3631 SW 87 Ave
Miami, Fl. 33165
Phone: (305) 485-8427
Fax: (305) 9485-8429
Hialeah Dental Care
4240 W 16 ave
Hialeah, Fl. 33012
Phone: (305) 823-1882
John Cabrera DMD.
Biscayne Dental Group
14771 Biscayne Blvd
North Miami, Fl. 33181
Phone: (305) 945-7745
Fax: (305) 945-7740
Cynthia Bouchard, DMD.
14771 Biscayne Blvd
Phone: (305) 945-7745
Fax: (305) 945-7740
Edgar K. Lopez, DMD.
14771 Biscayne Blvd
Phone: (305) 945-7745
Fax: (305) 945-7740
Dentistry / Odontología
Life Dental Care Corp.
123 N Powerline Rd.
Derfield Beach, Fl. 33442
Phone: (954) 429-8840
Fax: 954-429-8842
Broward
Pines Dental Care Inc.
302 NW 179 ave Suite 201-A
Phone: (954) 450-9383
Fax: 954-450-9385
Pines Dental Care II
17868 NW 2 ST
Phone: (954) 538-0047
Fax: 954-538-0924
Alberto Despaigne DDS.
2518 E. Hallandale Beach Blvd
Hallandale Beach, Fl. 33009
Phone: (954) 454-2504
Fax: 954-454-3289
37
GENERAL DENTISTRY FEES
ADA CODES
DESCRIPTION
Member Fees
D0120
PERIODIC ORAL EXAM
D0140
LIMITED ORAL EVALUATION-PROBLEM FOCUSED
NO CHARGE
D0150
COMPREHENSIVE ORAL EVAL-NEW OR ESTABLISHED PATIENT
D0160
DETAILED & EXTENSIVE EVAL-PROBLEM FOCUSED
NO CHARGE
D0170
RE-EVALUATION-LIMITED, PROBLEM FOCUSED
NO CHARGE
D0180
COMPREHENSIVE PERIODONTAL EVALUATION
$15.00
$10.00
$20.00
RADIOGRAPHY/DIAGNOSTIC DENTISTRY
D0210
X-RAY - INTRAORAL - COMPLETE SERIES (INCLUDING BITEWINGS)
$30.00
D0220
X-RAY - INTRAORAL - PERIAPICAL FIRST FILM
$15.00
D0230
X-RAY - INTRAORAL - PERIAPICAL EACH ADDITIONAL FILM
NO CHARGE
D0240
X-RAY - INTRAORAL - OCCLUSAL FILM
NO CHARGE
D0250
X-RAY - EXTRAORAL - FIRST FILM
NO CHARGE
D0260
X-RAY - EXTRAORAL - EACH ADDITIONAL FILM
NO CHARGE
D0270
X-RAY - BITEWING- SINGLE FILM
NO CHARGE
D0272
X-RAY - BITEWING - 2 FILMS
NO CHARGE
NOT TO BE TAKEN IF 274 WAS DONE W/IN PRIOR 6 MOS
D0330
PANORAMIC FILM
$25.00
D0340
CEPHALOMETRIC FILM, NON-ORTHODONTIC
$75.00
D0350
DIAGNOSTIC PHOTOGRAPHS
$20.00
D0460
PULP VITALITY TEST
$10.00
D0470
DIAGNOSTIC CASTS
$25.00
D1110
ROUTINE PROPHYLAXIS ADULT (ONCE EVERY 6 MONTHS)
PREVENTIVE DENTISTRY
38
$49.00
D1120
ROUTINE PROPHYLAXIS - CHILDREN UNDER 16 YRS (ONCE EVERY 6 MONTHS)
D1201
TOPICAL APPLICATION OF FLOURIDE FOR CHILDREN UNDER 16
NO CHARGE
$35.00
D1203
TOPICAL APPLICATION OF FLOURIDE FOR CHILDREN UNDER 16
NO CHARGE
D1204
TOPICAL APPLICATION OF FLOURIDE FOR ADULTS
D1310
NUTRITIONAL COUNSELING FOR CONTROL OF DENTAL DISEASE
NO CHARGE
D1320
TOBBACO COUNSELING FOR CONTROL & PREVENTION OF ORAL DISEASES
NO CHARGE
D1330
ORAL HYGIENE INSTRUCTIONS
NO CHARGE
D1351
APPLICATION OF SEALANT PER TOOTH - CHILDREN UNDER 16
$15.00
D1510
SPACE MAINTAINER - FIXED
$120.00
D1515
SPACE MAINTAINER - FIXED
$175.00
D1520
SPACE MAINTAINER - REMOVABLE
$160.00
D1525
SPACE MAINTAINER - REMOVABLE
$250.00
D1550
RE-CEMENTATION OF SPACE MAINTAINER
$25.00
D2330
RESIN-BASED COMPOSITE - 1 SURFACE, ANTERIOR (EMPASTES)
$60.00
D2331
RESIN-BASED COMPOSITE - 2 SURFACES, ANTERIOR (EMPASTES)
$70.00
D2332
RESIN-BASED COMPOSITE - 3 SURFACES, ANTERIOR (EMPASTES)
$80.00
D2335
COMPOSITED RESIN - 4 OR MORE SURFACES (EMPASTES)
$90.00
D2391
RESIN - BASED COMPOSITE - 1 SURFACE, POSTERIOR (EMPASTES)
$60.00
D2392
RESIN-BASED COMPOSITE - 2 SURFACES, POSTERIOR (EMPASTES)
$70.00
D2393
RESIN-BASED COMPOSITE - 3 SURFACES, POSTERIOR (EMPASTES)
$80.00
D2394
RESIN-BASED COMPOSITE - 4 OR + SURFACES, POSTERIOR (EMPASTES)
$90.00
D2410
GOLD FOIL - 1 SURFACE
$75.00
D2420
GOLD FOIL - 2 SURFACES
$95.00
D2430
GOLD FOIL - 3 SURFACES
$125.00
D2510
INLAY - METALLIC - 1 SURFACE
$300.00
$20.00
ADA CODES
DESCRIPTION
Member Fees
D2520
INLAY - METALLIC - 2 SURFACES
$320.00
D2530
INLAY - METALLIC - 3 OR MORE SURFACES
$340.00
D2542
ONLAY - METALLIC - 2 SURFACES
$325.00
D2543
ONLAY - METALLIC - 3 SURFACES
$330.00
D2544
ONLAY - METALLIC - 4 OR MORE SURFACES
$355.00
D2610
INLAY - PORCELAIN/CERAMIC - 1 SURFACE
$325.00
D2620
INLAY - PORCELAIN/CERAMIC - 2 SURFACES
$350.00
D2630
INLAY - PORCELAIN/CERAMIC - 3 OR MORE SURFACES
$375.00
D2642
ONLAY - PORCELAIN/CERAMIC - 2 SURFACES
$395.00
D2643
ONLAY - PORCELAIN/CERAMIC - 3 SURFACES
$415.00
D2644
ONLAY - PORCELAIN/CERAMIC - 4 OR MORE SURFACES
$445.00
D2650
INLAY - RESIN - BASED COMPOSITE - 1 SURFACE
$195.00
D2651
INLAY - RESIN - BASED COMPOSITE - 2 SURFACES
$250.00
D2652
INLAY - RESIN - BASED COMPOSITE - 3 OR MORE SURFACES
$275.00
D2662
ONLAY - RESIN - BASED COMPOSITE - 2 SURFACES
$250.00
D2663
ONLAY - RESIN - BASED COMPOSITE - 3 SURFACES
$275.00
D2664
ONLAY - RESIN - BASED COMPOSITE - 4 OR MORE SURFACES
$290.00
D2710
CROWN - RESIN (INDIRECT)
$210.00
D2720
CROWN - RESIN WITH HIGH NOBLE METAL
$455.00
D2721
CROWN - RESIN WITH PREDOMINNATLY BASE METAL
$405.00
D2722
CROWN - RESIN WITH NOBLE METAL
$425.00
D2740
CROWN - PORCELAIN/CERAMIC SUBSTRATE
$595.00
D2750
CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL
$495.00
D2751
CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL
$495.00
D2752
CROWN - PORCELAIN FUSED TO NOBLE METAL
$495.00
D2780
CROWN - 3/4 CAST HIGH NOBLE METAL
$530.00
D2781
CROWN - 3/4 CAST PREDOMINANTLY BASE METAL
$410.00
D2782
CROWN - 3/4 CAST NOBLE METAL
$520.00
D2783
CROWN - 3/4 PORCELAIN/CERAMIC
$550.00
D2790
CROWN - FULL CAST HIGH NOBEL METAL
$699.00
D2791
CROWN - FULL CAST PREDOMINANTLY BASE METAL
$525.00
D2792
CROWN - FULL CAST NOBLE METAL
$580.00
D2799
PROVISIONAL CROWN
$50.00
D2910
RECEMENT INLAY
$25.00
D2920
RECEMENT CROWN
$25.00
D2930
PREFABRICATED STAINLESS STEEL CROWN-PRIMARY TOOTH
$95.00
D2931
PREFABRICATED STAINLESS STEEL CROWN-PERMANENT TOOTH
$95.00
D2932
PREFABRICATED RESIN CROWN
$95.00
D2933
PREFABRICATED STAINLESS STEEL CROWN WITH RESIN WINDOW
$145.00
D2940
SEDATIVE FILLING
$40.00
D2950
CORE BUILDUP, INCLUDING ANY PINS
$85.00
D2951
PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION
$20.00
D2952
CAST POST & CORE IN ADDITION TO CROWN
$155.00
D2953
EACH ADDITIONAL CAST POST - SAME TOOTH
$105.00
D2954
PREFABRICATED POST & CORE IN ADDITION TO CROWN
$125.00
D2955
POST REMOVAL (NOT IN CONJUNTION WITH ENDODONTIC THERAPY)
$30.00
D2957
EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH
$30.00
D2960
LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE
$205.00
D2961
LABIAL VENEER (RESIN LAMINATE) - LABORATORY
$260.00
39
ADA CODES
40
DESCRIPTION
Member Fees
D2962
LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY
$425.00
D2970
TEMPORARY CROWN (FRACTURED TOOTH)
$50.00
D2980
CROWN REPAIR/ When crown and/or bridgework exceeds six(6) consecutive units,
there will be an additional charge of $30.00 per unit.
$95.00
ENDODONTICS SERVICES
D3110
PULP CAP-DIRECT (EXCLUDING FINAL RESTORATION)
$25.00
D3120
PULP CAP-INDIRECT (EXCLUDING FINAL RESTORATION)
$25.00
D3220
THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION)
$75.00
D3221
PUPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH
$95.00
D3230
PUPAL THERAPY (RESORB FILLING) - ANTERIOR, PRIMARY
$80.00
D3240
PUPLAM THERAPY (RESORBABLE FILLING) - POSTERIOR, PRIMARY
$90.00
D3310
ROOT CANAL THERAPY - ANTERIOR
$395.00
D3320
ROOT CANAL THERAPY - BICUSPID
$495.00
D3330
ROOT CANAL THERAPY - MOLAR
$595.00
D3331
TREATMENT OF ROOT CANAL OBSTRUCTION, NON-SURGICAL ACCESS
$85.00
D3346
RETREAT, PREV RCT - ANTERIOR
$495.00
D3347
RETREAT, PREV RCT - BICUSPID
$595.00
D3348
RETREAT, PREV RCT - MOLAR
$695.00
D3950
CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST
$75.00
D4211
GINGIVECTOMY/GINGIVOPLASTY - 1 TO 3 TEETH, PER QUAD
D4220
GINGIVAL CURETTAGE PER QUADRANT EXCLUDING ROOT PLANNING
$75.00
D4240
GINGIVAL FLAP PROCEDURE- 4 OR MORE
$325.00
D4241
GINGIVAL FLAP PROCEDURE - 1 TO 3 TEETH PER QUAD
$250.00
D4245
APICALLY POSITIONED FLAP
$150.00
D4341
PERIODONTAL SCALING & ROOT PLANING - 4 OR MORE CONTIGUOUS TEETH
$75.00
D4342
PERIODONTAL SCALING $ ROOT PLANING - 1 TO 3 TEETH, PER QUAD
$60.00
D4355
FULL MOUTH DEBRIDEMENT TO ENABLE COMPREHENSIVE EVALUATION
$80.00
D4381
LOCAL DELIVERY ANTIBIOTIC (ARESTIN)
$30.00
D4910
PERIODONTAL MAINTENANCE
$55.00
PERIODONTICS SERVICES
$50.00
D5110
COMPLETE DENTURE - MAXILLARY BASIC
$495.00
D5120
COMPLETE DENTURE - MANDIBULAR BASIC
$495.00
D5211
MAXILLARY PARTIAL DENTURE - RESIN BASE (INCLUDING CLASPS)
$450.00
D5212
MANDIBULAR PARTIAL DENTURE - RESIN BASE (INCLUDING CLASPS)
$450.00
D5213
PARTIAL DENTURE - MAXILLARY CAST METAL - ACRYLIC
$575.00
D5214
PARTIAL DENTURE - MANDIBULAR VAST METAL - ACRYLIC
$575.00
D5410
ADJUSTMENT - COMPLETE DENTURE - MAXILLARY
$20.00
D5411
ADJUSTMENT - COMPLETE DENTURE - MANDIBULAR
$20.00
D5421
ADJUSTMENT - PARTIAL DENTURE - MAXILLARY
$20.00
D5422
ADJUSTMENT - PARTIAL DENTURE - MANDIBULAR
$20.00
D5510
REPAIR BROKEN COMPLETE DENTURE BASE
$75.00
D5520
REPLACE BROKEN TOOTH - COMPLETE DENTURE (EACH TOOTH)
$70.00
D5610
REPAIR DENTURE RESIN BASE
$50.00
D5620
REPAIR CAST FRAMEWORK
$55.00
D5630
REPAIR OR REPLACE BROKEN CLASP
$55.00
D5640
REPAIR BROKEN TEETH - PER TOOTH
$45.00
D5650
ADD TOOTH TO EXISTING PARTIAL DENTURE
$65.00
D5660
ADD CLASP TO EXISTING PARTIAL DENTURE
$75.00
D5710
REBASE COMPLETE MAXILLARY DENTURE
$195.00
D5711
REBASE COMPLETE MANDIBULAR CENTURE
$195.00
ADA CODES
DESCRIPTION
Member Fees
D5720
REBASE MAXILLARY PARTIAL DENTURE
$175.00
D5721
REBASE MANDIBULAR PARTIAL DENTURE
$175.00
D5730
RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE)
$85.00
D5731
RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE)
$85.00
D5740
RELINE PARTIAL COMPLETE MAXILLARY DENTURE (CHAIRSIDE)
$65.00
D5741
RELINE PARTIAL COMPLETE MANDIBULAR DENTURE (CHAIRSIDE)
$65.00
D5750
RELINE COMPLETE MAXILLARY DENTURE (LABORATORY)
$150.00
D5751
RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY)
$150.00
D5760
RELINE PARTIAL MAXILLARY DENTURE (LABORATORY)
$110.00
D5761
RELINE PARTIAL MANDIBULAR DENTURE (LABORATORY)
$110.00
D5810
INTERIM COMPLETE DENTURE - MAXILLARY
$250.00
D5811
INTERIM COMPLETE DENTURE - MANDIBULAR
$250.00
D5820
INTERIM PARTIAL DENTURE - MAXILLARY
$250.00
D5821
INTERIM PARTIAL DENTURE - MANDIBULAR
$250.00
D5850
TISSUE CONDITIONING - MAXILLARY
$55.00
D5851
TISSUE CONDITIONING - MANDIBULAR
$55.00
D5862
PRECISION ATTACHMENT
$150.00
PROSTHODONTICS - FIXED
D6210
PONTIC - CAST HIGH NOBLE METAL
$400.00
D6211
PONTIC - CAST PREDOMINANTLY BASE METAL
$400.00
D6212
PONTIC - CAST NOBLE METAL
$400.00
D6240
PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL
$400.00
D6241
PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL
$400.00
D6242
PONTIC - PORCELAIN FUSED TO NOBLE METAL
$400.00
D6245
PONTIC - PORCELAIN/CERAMIC
$595.00
D6740
CROWN - PORCELAIN/CERAMIC
$595.00
D6750
CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL
$495.00
D6751
CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASED METAL
$495.00
D6752
CROWN - PORCELAIN FUSED TO NOBLE METAL
$495.00
D6780
CROWN - 3/4 CAST HIGH NOBLE METAL
$530.00
D6781
CROWN - 3/4 CAST PREDOMINANTLY BASED METAL
$510.00
D6782
CROWN - 3/4 CAST NOBLE METAL
$520.00
D6783
CROWN - 3/4 PORCELAIN/CERAMIC
$510.00
D6790
CROWN - FULL CAST HIGH NOBLE METAL
$495.00
D6791
CROWN - FULL CAST PREDOMIANTLY BASED METAL
$495.00
D6792
CROWN - FULL CAST NOBLE METAL
$495.00
D6930
RECEMENT FIXED PARTIAL DENTURE
$40.00
D6950
PRECISION ATTACHMENT
$150.00
D6970
CAST POST & CORE ADDITION TO FIXED PARTIAL DENTURE RETAINER
$125.00
D6971
CAST POST AS PART OF A FIXED PARTIAL DENTURE RETAINER
$125.00
D6972
PREFABRICATED POST & CORE IN ADDITION TO FIXED PARTIAL DENTURE
$125.00
D6973
CORE BUILD UP FOR RETAINER, INCLUDING PINS
$95.00
D6975
COPING - METAL
$95.00
D7110
SINGLE TOOTH EXTRACTION (EXTRACCION)
$70.00
D7140
EXTRACTION OF ERUPTED TOOTH OR EXPOSED ROOT
$70.00
D7310
ALVEOLOPLASTY WITH EXTRACTIONS - PER QUADRANT
$95.00
D7320
ALVEOLOPLASTY WITHOUT EXTRACTIONS - PER QUADRANT
$130.00
D7510
INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE
$55.00
ORAL SURGERY
41
ADA CODES
MISCELLANOUS SERVICES
Member Fees
D9215
LOCAL ANESTHESIA
D9230
ANALGESIA NITROUS OXIDE PER 1/2 hour
NO CHARGE
D9630
ORAL IRRIGATION/OTHER DRUGS/MEDICAMENT PER QUAD
$10.00
D9940
OCCLUSAL GUARD
$195.00
D9950
OCCLUSAL ANALYSIS - MOUNTED CASE
$75.00
D9951
OCCLUSAL ADJUSTMENT - LIMITED
$25.00
D9952
OCCLUSAL ADJUSTMENT - COMPLETE
$150.00
$20.00
*The basic cleaning does not apply if you have any periodontal disease.
* The dental procedures not listed in your pricing list will apply to a discount of 25%. The dentists and
specialists are the only responsible parties for the treatment and its charges. Med Plan is not responsible
for payments nor for orthodontics indications performed by the dentists or specialists associated with our
plan.
*La limpieza simple no aplica si Usted tiene evidencia de enfermedad periodontal.
*A los procedimientos que no aparecen en su lista de precios se les aplicara un descuento del 25% de lo usual y
razonable. Los dentistas y especialistas son los unicos responsables por el tratamiento y precio del mismo. Med
Plan no es responsable por los pagos ni por las indicaciones odontologicas hechas por los dentistas y especialistas asociados a nuestro plan.
42
DENTAL SPECIALTIES FEES
ADA CODES
ENDODONTICS
Member Fees
D3310
ROOT CANAL THERAPY - ANTERIOR
$695.00
D3320
ROOT CANAL THERAPY - BICUSPID
$775.00
D3330
ROOT CANAL THERAPY - MOLAR
$925.00
D3346
RETREAT, PREV RCT - ANTERIOR
$750.00
D3347
RETREAT, PREV RCT - BICUSPID
D3348
RETREAT. PREV RCT - MOLAR
D4210
D4249
GINGIVECTOMY 4 OR + PER QUADRANT
CLINIC CROWN LENGTHEN - HARD TISSUE
$450.00
$800.00
D4260
OSSEOUS SURGERY 4 OR + PER QUADRANT
$900.00
D4263
BONE REPLACE GRAFT - 1ST SITE/QU
$650.00
D4264
BONE REPLACE GRAFT - EACH ADD/QU
$500.00
D4266
GUIDED TISS REGEN-RESORB-PER
$900.00
D4275
SOFT TISSUE ALLOGRAFT RB-PER
$1,200.00
D7953
BONE REPL GRAFT RIDGE PRSV/SITE
$400.00
D7960
FRENULECTOMY - SEPARATE PROCEDURE
$500.00
D7210
EXTRACTION - SURGICAL/ERUPT TOOTH
$240.00
D7220
EXTRACTION - IMPACTEDL/SOFT TISSUE
$300.00
D7230
EXTRACTION - IMPACTEDL/PART BONY
$395.00
D7240
EXTRACTION - IMPACTED/COMPLBONY (Cordales)
$450.00
D7241
REMOV IMPACT - COMP BONY W/COMP
$500.00
D7250
SURGIC REMOVL RESID TOOTH ROOT
$250.00
D7285
BIOPSY OF ORAL TISSUE - HARD (BONE, TOOTH)
$120.00
D7286
BIOPSY OF ORAL TISSUE - SOFT (ALL OTHER)
$95.00
BIOPSY LAB
$50.00
$825.00
PERIODONTICS
ORAL SURGERY
ORTHODONTICS
$1,125.00
D8080
COMPREHENSIVE ORTHO, ADOLESCENT
$3,490.00
D8090
COMPREHENSIVE ORTHO, ADULT
$3,490.00
D6010
SURG PLACE IMPLANT, ENDOSTEAL
$1,200.00
COMPLETED CROWN IMPLANT (IMPLANTE Y CORONA)
$1,950.00
D6010/D6059
IMPLANTS
D0000
OVERDENTURE UPPER WITH 4 IMPLANTS
$4,650.00
D0000
OVERDENTURE LOWER WITH 3 IMPLANTS
$3,650.00
*The basic cleaning does not apply if you have any periodontal disease.
* The dental procedures not listed in your pricing list will apply to a discount of 25%. The dentists and
specialists are the only responsible parties for the treatment and its charges. Med Plan is not responsible
for payments nor for orthodontics indications performed by the dentists or specialists associated with our
plan.
*La limpieza simple no aplica si Usted tiene evidencia de enfermedad periodontal.
*A los procedimientos que no aparecen en su lista de precios se les aplicara un descuento del 25% de lo usual y
razonable. Los dentistas y especialistas son los unicos responsables por el tratamiento y precio del mismo. Med
Plan no es responsable por los pagos ni por las indicaciones odontologicas hechas por los dentistas y especialistas asociados a nuestro plan.
43
VISION CENTERS / CENTROS DE VISION
Our members will receive a comprehensive eye exam(s) with a $35 visit which includes:
• Vision Evaluation.
• Intraocular Pressure Evaluation to check for Glaucoma.
• Dilated Eye Exam to determine eye health and to look for disease such as high blood pressure and diabetes.
• External eye health evaluation
Nuestros miembros recibirán un (1) examen ocular completo con un costo de $ 35.00 que incluye:
• Evaluacion de la vista - (Optometría)
• Evaluación de la Presión Intraocular para verificar evidencia de glaucoma.
• Dilatación de la pupila para determinar la salud y para identificar enfermedades tales como presión alta o diabetes.
• Evaluación externa para determinar la salud de los ojos.
Optical & Vision Centers / Centros Opticos
Miami - Dade
(SOUTH FLORIDA VISION). **
Harrold Forrest, O.D
James Hagen, O.D
Martha Alfonso, O.D.
(Navarro Pharmacy # 32)
366 East 4th Avenue.
Hialeah, Fl. 33010
Phone: (305) 888-9910
Martha Alfonso, OD.
Harrold Forrest, OD.
James Hagen OD.
(Navarro Pharmacy # 25)
11865-A SW 26th Street.
Miami, Fl. 33175
Phone: (305) 552-9100 / (305) 225-4004
(VISION CENTER OPTICA). **
Gerald D. Furnari O.D. F.A.A.O.
Robert L. Lofton O.D. F.A.A.O.
Patrick F. Vecchio O.D. F.A.A.O.
948 N. Krome Ave
Phone: (305) 247-2331
(TRIANGLE VISION CENTER.) ***
(Vision Center/ Optica)
1750 West 39 Place
Hialeah, FL 33012
Phone: (305) 490-3816
Lang. English / Spanish
(MARICEL OPTICAL). **
5663 NW 195 Dr.
Miami Florida 33055
Phone: (305) 626-9534
(OPTICA ARIAS). **
Hialeah Gardens , Fl. 33018
Phone: (305) 512-4408
(VISION CENTER OPTICA). **
Gerald D. Furnari O.D. F.A.A.O.
Robert L. Lofton O.D. F.A.A.O.
Patrick F. Vecchio O.D. F.A.A.O.
6201 SW 70 Street, Suite 302
Miami Florida 33143
Phone: (305) 665-5712
Note: ( ** ) Evaluation includes Intraocular Exam to Detect Glaucoma, Diabetes and High Blood Pressure.
Nota: ( ** ) La evaluación incluye Examen Intraocular para verificar si hay Glaucoma, Diabetes y Presión Alta.
Note: ( *** ) Evaluation does NOT include Intraocular Exam to Detect Glaucoma, Diabetes and High Blood Pressure.
Nota: ( *** ) La evaluación NO incluye Examen Intraocular para verificar si hay Glaucoma, Diabetes y Presión Alta.
44
Eric Dupuis, OD.
Christopher Boalding, OD.
Laurie Lesser, OD.
2551 South University Drive
Davie, Fl. 33324
Phone: (954) 370-5883
Fax: (954) 370-8799
Eric Dupuis, OD.
Christopher Boaldin, OD.
Robert Coppola, OD.
2900 W. Cypress Creek Rd. # 1
Ft. Lauderdale Fl. 33309
Phone: (954) 979-2191
Fax: (954) 979-8988
Laura DeMarco, OD.
1666 East Oakland Park Blvd..
Ft. Luderdale Fl. 33334
Phone: (954) 566--1404
Fax: (954) 566-0291
Harold Forrest, OD.
Laurie Lesser, OD.
12538 Pines Blvd.
Phone: (954) 430-4030
Ashley Nochomson, OD.
Karen Puchalski, OD.
Miriam Farag, OD.
9851- B South Military Trail.
Boynton Beach, Fl. 33436
Phone: (561) 742-8701
Fax: (561) 742-4212
143 N. Powerline Road
Deerfield Beach, Fl. 33442
Phone: (954) 429-9600
Fax: (954) 429-9956
Mitchell Biderman, OD.
Lori Raynor, OD.
6618 West. Atlantic Ave.
Delray Beach, Fl. 33446
Phone: (561) 498-5007
Fax: (561) 496-3088
Mitchell Biderman, OD.
Lori Raynor, OD.
Ashley Nochomson, OD.
6266 S. Congress Ave. # 9
Lantana, Fl. 33462
Phone: (561) 966-9000
Broward
Mirian Faraq, OD.
Jerrold Mills, OD.
3181 North State Rd. # 7
Margate Fl. 33063
Phone: (954) 974-7695
Fax: (954) 974-4211
Robert Coppola, OD.
1205 S. Powerline Rd.
Pompano Beach, Fl. 33069
Phone: (954) 977-6636
Fax: (954) 977-3822
Palm Beach
Ronie Zaruches, OD.
143 N. Powerline Road
Phone: (954) 429-9600
Fax: (954) 429-9956
Jason Aronson, OD.
2905-G N. Military Trail
West Palm Beach, Fl. 33409
Phone: (561) 684-5548
Fax: (561) 684-6229
St. Lucie
(ST. LUCIE VISION CENTER). **
Mitchell Biderman, OD. **
10077 South Federal Hwy.
Port St. Lucie, Fl. 34952
Phone: (772) 398-3244
Fax: (772) 398-8090
45
Ft. Myers
(VISTA VISION EYE CARE). **
12320 South Cleveland Ave.
Ft. Myers Fl. 33907
Phone: (239) 936-5591
46
47
CLINICAL LABS / LABORATORIOS CLINICOS
Services Details
Over One thousand “1000” Lab tests available 80% of the tests are priced below $20.00.
Five Complementary Lab tests free for all Med Plan members and their family once a year. Included tests are:
• CBC.
• Comprehensive Metabolic Panel.
• Lipid Profile.
• TSH
• Urinalysis.
All Laboratories require that the tests being requested are ordered by a licensed healthcare professional that is authorized
to practice medicine in the State of Florida. The order must be written in a Physicians prescription or on the Laboratories
requisition form that is signed by the ordering physician.
All Laboratory results will be sent to the office of the Physician or Specialist that has ordered the test. This procedure is to
protect the confidential information regarding the outcome or the test results.
Detalles de los Servicios
De las pruebas de laboratorio disponibles, el 80% de su totalidad están bajo precios fijos.
MedPlan ha coordinado con sus laboratorios asociados que ofrecen precios preferenciales a nuestros miembros en varios
exámenes y además cinco (5) exámenes complementarios cada año sin costo alguno para usted.
• CBC.
• Panel metabólico completo.
• Perfil de lípitdos.
• TSH (Tiroides)
• Análisis de orina.
Todos los laboratorios requieren que los exámenes que se solicitan hayan sido previamente indicados por un profesional de
la salud con licencia que le autoriza a ejercer la práctica de la medicina en el Estado de la Florida. La indicación del examen
debe estar escrita en una receta médica o en su lugar en el formulario de solicitud establecida para los Laboratorios y
firmada por el médico que la indica.
Todos los laboratorios cumplirán el procedimiento legal establecido de confidencialidad del paciente y para proteger este
derecho enviaran los resultados de su/s examen a la oficina de su doctor.
48
Clinical Labs / Laboratorio Clínico
Complete Bio Solutions
7200 NW 7 ST # 202
Miami, Fl. 33126
Phone: (305) 267-7784
Veni puncture Fee: $10.00
Florida Reference Laboratory.
4278 SW 71 ave
Miami, Fl. 33155
Phone: (305) 662-2626
Fax: (305) 667-5870
Veni puncture Fee: Free
50 NW 15 ST # 103
Phone: (305) 245-5188
3150 Northside Drive, Building F
Key West, Fl. 33040
Phone: (305) 292-3231
10550 NW 77 Court
Hialeah, Fl. 33016
Phone: (305) 826-3072
5850 West Flagler ST
Miami, Fl. 33144
Phone: (305) 263-9590
3720 SW 107 ave
Miami, Fl. 33165
Phone: (305) 554-4270
8651 NW 56 ST
Miami, Fl. 33166
Phone: (305) 477-6520
Miami - Dade
8740 N. Kendall Dr. # 107 A
Miami, Fl. 33176
Phone: (305) 270-9944
13303 SW 42 ST
Miami, Fl. 33175
Phone: (305) 227-6497
FREE LAB TESTS AT ALL FLORIDA REFERENCE LABS AND COMPLETE BIO SOLUTIONS LABS.
ANALISIS GRATIS EN TODOS LOS FLORIDA REFERENCE LABS Y COMPLETE BIO SOLUTIONS LABS.
Clinical Labs / Laboratorio Clínico
CM Lab, Inc.
9872 Pines Blvd.
Phone: (954) 704-9116
Fax: (954) 704-8823
Refer to Fee Schedule
CM Lab, Inc.
2523 North State Road 7
Margate, Fl. 33063
Phone: (754) 224-4152
Fax: (954) 590-6551
Broward
First Quality Lab*
11460 Interchange
Circle North
Miramar, Fl. 33025
Phone: (954) 430-4424
FREE LAB TESTS ONLY AT “FIRST QUALITY LAB”
ANALISIS DE LABORATORIO GRATIS SOLAMENTE EN “FIRST QUALITY LAB”
HOME LABORATORY SERVICES UP TO WEST PALM BEACH
FLEBOTOMIA A DOMICILIO HASTA WEST PALM BEACH
49
INDEPENDENT LABORATORY SERVICES FEE SCHEDULE
ANNUAL FREE PANEL FOR PATIENTS
ANALISIS GRATIS UNA VEZ AL AÑO
CBC
COMP. METABOLIC PANEL
TSH
LIPID PANEL
URINE
PATHOLOGY TEST / EXAMENES DE PATOLOGIA
TEST NAME
PAP SMEAR (slide)
PAP LIQUID SUREPATH
HUMAN PAPILOMA VIRUS hc2
CHLAMYDIA & GC DNA
CHLAMYDIA & GC DNA hc2
PAP PANEL (liquid pap+HPVhc2+chlamydia&GC hc2
TEST CODE
9161
9142
1845
5344
9193
9190
PRICE
$12.00
$25.00
$38.00
$25.00
$35.00
$99.00
TEST CODE
PRICE
9181
9182
9183
9184
$30.00
$40.00
$65.00
$85.00
All the Gynecology collections will cost $20.
Todas las colecciones ginecologicas tendran un costo de $20.
*The prices of the biopsies level (I-II-III-IV-V-VI) will be
determined by the specimen site, number of the specimens
and any special stains required for the final diagnosis.
BIOPSY Level I - Gross only
BIOPSY Level II
BIOPSY Level III
BIOPSY Level IV
50
TEST NAME
A
TEST CODE
PRICE
AMYLASE
ACTH (ADRENOCORTICOTROPIC HORMONE)
AFP TUMOR MARKER
ALBUMIN
ALCOHOL IN URINE
ALDOLASE
ALKALINE PHOSPHATASE
ALLERGEN FOOD PANEL (ADULT) each allergen ($9)
ALLERGEN RESPIRATORY PANEL(SUB-TROPICAL) each allergen ($9)
ALLERGY PANEL PER ALLERGEN each allergen ($9)
ALPHA PHETO PROTEIN QUAD SCREEN
ALPHA PHETO PROTEIN TRIPLE SCREEN
ALT (SGPT)
AMIKACIN SERUM
AMMONIA
ANA
ANTIBODY SCREENING
ASO
1106
7200
1274
8170
3525
1102
8160
7302
7304
1673
8260
8154
1695
1104
5200
4259
4201
$6.00
$37.00
$15.50
$2.50
$12.00
$9.50
$2.50
$9.00
$9.00
$9.00
$82.00
$56.00
$8.00
$15.50
$12.50
$12.00
$11.50
$15.00
AST (SGOT)
8152
$8.00
B-12 & FOLID ACID
8794
$30.00
B-12
7272
$12.50
BASIC METAB PANEL
8118
$8.00
BETA 2 MICROGLOBULIN
1404
$16.50
BILIRUBIN DIRECT
8149
$4.50
BILIRUBIN TOTAL
8166
$4.50
BIOPSY (see comments at the end)
9181
BLEEDING TIME
4108
$4.50
BLOOD TYPE & RH
4200
$18.00
BNP
1430
$40.00
BUN
8142
$5.00
CBC
4110
$7.00
C3 COMPLEMENT
6115
$20.00
C4 COMPLEMENT
6126
$20.00
CA 125
1462
$19.50
CA 15-3
1462
$19.50
CA 19-9
1463
$19.50
B
C
51
TEST NAME
TEST CODE
1664
8172
2130
1318
3119
7214
6119
5346
5344
8146
8156
1353
5210
8112
4214
4215
7206
1431
6127
PRICE
$19.50
$4.50
$11.00
$27.00
$15.00
$19.50
$36.00
$60.00
$25.00
$4.50
$7.00
$14.50
$12.50
$9.00
$10.00
$10.00
$17.50
$15.00
$12.50
C-REACTIVE PROTEIN - QUANT
C-REACTIVE PROTEIN (CRP)
3595
4216
$12.50
$5.00
C-REACTIVE PROTEIN (CRP) ULTRASENSITIVE
6657
$12.50
CREATININE 24 HRS
2115
$10.00
CREATININE CLEARANCE
2127
$9.50
CREATININE SERUM
8150
$4.00
CULTURE & SENSIT
5145
$14.00
CYSTIC FIBROSIS
6442
$250.00
DEPAKENE (VALPROIC ACID)
1938
$14.00
DHEA (DEHYDROEPIANDROSTERONE
7171
$26.00
DHEA-S
1655
$26.00
CA 27-29
CALCIUM
CALCIUM IONIZED
CALCULUS (stone) ANALYSIS
CARBAMAZEPIN
CEA
CERULOPLASMIN
CHLAMYDIA & GC IN URINE
CHLAMYDIA & GC DNA
CHOLESTEROL
CK (CPK TOTAL)
CMV IgG
CMV IgM
COMPRENH. METABOLIC PANEL
COOMBS DIRECT
COOMBS INDIRECT
CORTISOL
C-PEPTIDE
CPK - MB (CREATINE KINASE MB FRACTION)
D
DIHYDROTESTOSTERONE DHT
$26.50
D-DIMER
$22.50
DILANTIN LEVEL
3126
$15.00
DRUG SCREEN IN URINE
3223
$23.00
ELECTROLYTE PANEL
8200
$6.50
EPSTEIN BARR VIRAL CAPSIDE ANTIGEN (VCA) IgG & IgM
1920
$14.00
EPSTEIN BARR VIRUS EARLY
1632
$14.00
E
52
TEST NAME
EPSTEIN BARR VIRUS NUCLEAR ANTIGEN IgG ANTIBODY
EPSTEIN BARR VIRUS NUCLEAR ANTIGEN IgM ANTIBODY
ERYTHROPOIETIN
ESTRADIOL
ESTRIOL
ESTROGEN TOTAL
ESR (SED RATE)
EYE CULTURE & SENSITIVITY
F
FERRITIN
FIBRINOGEN
FOLIC ACID
FREE T3
FREE T4
FSH
FSH&LH
FINE NEEDLE ASPIRATION
FTA AG
FUNGUS CULTURE
TEST CODE
1861
1902
5215
7226
7224
7227
4160
5145
PRICE
$17.50
$17.50
$18.50
$22.00
$28.00
$22.00
$8.00
$12.00
7275
4223
7229
1603
7120
7228
7261
5220
5114
$14.00
$22.00
$13.00
$7.00
$7.00
$17.00
$34.00
$69.00
$35.00
$35.00
GAMMA GT (GGTP)
1116
$5.00
GC CULTURE
5118
$35.00
GENTAMYCIN
7232
$28.00
GLIADIN IgA, IgG
1432
$80.00
GLUCOSE 2 HRS P.P
8180
$7.00
GLUCOSE 2 HRS TOLERANCE TEST
8188
$13.00
GLUCOSE 3 HRS
8189
$17.00
GLUCOSE GRAY TUBE
8141
$3.50
GLUCOSE SERUM
8140
$3.50
GLYCOHEMOGLOBIN
6145
$9.00
H. PYLORI AB IgG
1295
$15.00
H.PYLORI AB IgM
1297
15.00
H.PYLORI IN STOOL (ANTIGEN)
1294
$43.00
HAPTOGLOBULIN
6147
$25.00
HCG QUAL
7282
$7.00
HCG QUANT
7240
$15.50
HEMOGLOBIN A1C
6145
$9.50
HEMOGLOBIN ELECTROPHORESIS
6151
$12.00
G
H
53
TEST NAME
HEMOGLOBIN/HEMATOCRIT
HEPATIC FUNCTION PANEL
HEPATITIS A IgM
HEPATITIS A TOTAL
HEPATITIS B CORE IgM ANTIBODIES
HEPATITIS B CORE TOTAL ANTIBODY
HEPATITIS Bs ANTIBODY
HEPATITIS Bs ANTIGEN
HEPATITIS C ANTIBODY
HEPATITIS PANEL ABC
HERPES CULTURE
HERPES I SELECT
HERPES SELT II IgG
HIV 1 & 2 SCREEN
HLA-B-27
HOMOCYSTEINE
HUMAN GROWTH HORMONE
HUMAN PAPILOMA VIRUS hc2
I
TEST CODE
4132
8698
1376
1621
1799
1614
7237
7236
1711
2298
1716
1439
1440
1437
1398
1227
7238
1846
PRICE
$12.00
$7.50
$11.50
$10.50
$11.50
$11.50
$11.00
$10.00
$13.50
$44.00
$35.00
$12.50
$18.50
$9.50
$70.00
$28.00
$16.00
$39.00
IgA (Immunoglobulin)
IgE (Immunoglobulin E)
6140
7248
$9.00
$16.00
IgG (Immunoglobulin)
6142
$9.00
IgM (Immunoglobulin M)
6143
$9.00
IMMUNOELECTROPHORESIS
6160
$21.50
IMMUNOGLOBULIN IgG-A-M
6156
$27.00
INSULINE LEVEL
7250
$11.50
INSULINE LIKE GROWTH FACTOR I SOMATOMEDIN-C IgF1
1666
$30.00
IRON
8162
$5.00
IRON & IBC
8161
$8.50
LEAD BLOOD
2160
$10.50
L.E. SCREEN
3662
$10.00
LDH
8158
$4.00
LH
7244
$19.50
LIPASE
1126
$6.50
LIPID PANEL
6188
$9.00
LIPOPROTEIN A
6165
$33.20
LITHIUM
2163
$7.00
LIVER PROFILE I
8158
$10.00
L
54
TEST NAME
M
TEST CODE
PRICE
MAGNESIUM SERUM
MEASLES ANTIBODY IgG
MEASLES ANTIBODY IgM
METANEPHRINE 24 HRS URINE
MICROALBUMIN 24 HRS URINE
MICROALBUMIN RANDOM
MITOCHONDRIAL TOTAL AUTOANTIBODIES
MONO TEST
MUMPS ANTIBODY IgG
MUMPS ANTIBODY IgM
MYCOPLASMA IgM TITER PNEUMONIAE ANTIBODY
MYCOPLASMA PNEUMONIAE ANTIBODY IgG, IgM
MYELIN BASIC PROTEIN (MBP) AUTOANTIBODIES
MYSOLINE (PRIMIDONE)
N
NEURONTIN (GABAPENTIN)
NICOTINE METABOLITE URINE
O
2166
2362
2361
2169
1208
1209
5226
4213
1362
1317
1985
1363
1404
3162
$6.50
$12.50
$12.50
$80.00
$35.00
$4.00
$55.00
$12.00
$12.50
$12.50
$60.00
$65.00
$90.00
$55.00
1609
3198
$50.00
$24.50
OBSTETRIC PANEL
OCCULT BLOOD PER SPECIMEN
8136
4320
$45.23
$5.00
OVA AND PARASITES
4321
$9.00
OXALATES - 24HRS
2173
$13.00
OXALATES - URINE RANDOM
2172
$13.00
PAP SMEAR
9161
$15.00
PAP LIQUID SUREPATH
9142
$25.00
PHENOBARBITAL
3155
$11.00
PHOSPHORUS
8174
$4.00
PLATELET COUNT
4149
$6.00
POTASIUM
8210
$4.00
POTASIUM IN URINE
8223
$4.00
PRE - ALBUMIN
2011
$7.00
PREGNANCY TEST IN URINE
4330
$6.50
PRIMIDONE
3162
$15.00
PROCAINAMIDE (PRONESTYL + NAPA)
3163
$16.50
PROGESTERONE
7256
$26.00
PROLACTIN
7252
$19.50
PROTEIN ELECTROPHORESIS
6129
$10.00
P
55
TEST NAME
TEST CODE
2305
8168
2216
1937
4254
1373
4253
PRICE
$3.50
$5.00
$29.00
$15.00
$3.50
$35.00
$3.50
2183
$14.50
R A LATEX
RENAL FUNCTION PANEL
RENIN
RETIC COUNT
RH FACTOR (ONLY)
RHEUMATOID FACTOR
RUBELLA ANTIBODY IgG
RUBELLA ANTIBODY IgM
RPR
4257
8108
7258
4154
4202
4257
5230
1752
4272
$7.00
$8.00
$18.50
$4.00
$5.50
$6.00
$15.00
$15.00
$4.50
RUBELLA ANTIBODY IgM
1752
$15.00
SED RATE
4160
$3.50
SEMEN ANALYSIS
4331
$50.00
SEROTONIN (5-HIAA)
2186
$11.00
SICKLE CELL SCREEN
4161
$6.00
SMOOTH MUSCLE ANTIBODY
1601
$30.00
SODIUM (U) 12 HRS
2334
$4.50
SODIUM (U) 24 HRS
2335
$4.50
SODIUM IN URINE
8221
$4.50
SODIUM SERUM
8205
$4.00
STONE ANALYSIS (KIDNEY)
1318
$27.00
STOOL CULTURE
5113
$13.50
T-3 FREE
1603
$7.00
T3 TOTAL
7260
$7.00
T3-UPTAKE
7105
$6.00
T4
7110
$6.00
TACROLIMUS (PROGRAF)
1282
$16.00
TESTOSTERONE
7268
$25.00
PROTEIN TOTAL 24HRS
PROTEIN TOTAL SERUM
PSA FREE & TOTAL
PSA SCREEN
PT
PTH INTACT
PTT
Q
QUINIDINE
R
S
T
56
TEST NAME
TESTOSTERONE FREE & TOTAL
THEOPHYLLINE
THIAMINE LEVEL (VITAMIN B1)
THROAT CULTURE
THYROGLOBULIN Abs SCREEN
THYROGLOBULIN QUANT.
THYROID II PANEL (TSH)
THYROID PEROXIDE AB (TPO)
THYROID STIMULATING IMMUNOGLOBULINS (TSI)
THYROXIDE BINDING GLOBULIN
TOBRAMYCIN
TORCH PANEL
TOXOPLASMA IgG
TRANSFERRIN
TRAZODONE
TREPONEMA PALLIDUM TOTAL ANTIBODIES (FTA)
TRIGLYCERIDES
TROPONIN I
TSH
TEST CODE
7269
3174
7175
5155
5202
1201
7121
5205
1389
1391
3185
8420
5236
6175
1798
5220
8148
8157
7264
PRICE
$27.50
$14.50
$6.00
$13.50
$16.00
$14.00
$29.00
$15.00
$12.50
$11.00
$16.00
$60.00
$15.00
$15.00
$70.00
$22.00
$6.00
$15.50
$14.00
URINALYSIS
4340
$2.00
URIC ACID
8144
$3.00
URINE CULTURE
5113
$13.50
U
URINE CYTOLOGY
$25.00
V
VARICELLA ANTIBODY IgG
2772
$15.00
VITAMIN D25
1300
$33.50
VITAMIN D
1301
$33.50
VITAMIN B-6
1346
$14.00
VAGINAL CULTURE
5156
$13.50
VARICELLA ZOSTER ANTIBODY IgM
2772
$15.00
VITAMIN B-1 (THIAMINE)
7175
$6.00
VMA (VANILLYLMANDELIC ACID 24 HRS URINE)
2196
$12.50
VALPROIC ACID
1938
$14.00
VITAMIN B-12
7272
$15.00
1833
$35.00
W
WESTERN BLOT ANALYSIS
WET MOUNT
$4.00
WBC IN STOOL
4319
$8.00
2199
$11.50
Z
ZINC
57
DIAGNOSTICS / CENTROS DE DIAGNOSTICO
Services Details
Over 300 Diagnostic Tests available which include:
• Digital Mammography
• MRI
• CT Scans
• PET CT Scans
• Ultra Sound
• X-Rays
• Sleep Studies
All Diagnostic Centers requires that the tests being requested are ordered by a licensed healthcare professional that is
authorized to practice medicine in the State of Florida. The order must be written in a Physicians prescription or on the
Diagnostic Centers requisition form that is signed by a physician.
All test results will be sent to the office of the Physician or Specialist that ordered the test. This procedure is to protect the
confidential information regarding your health.
Más de trescientos (300) procedimientos de diagnóstico están disponible e incluyen:
• Mamografia Digital
• Tomografia computaizada
• CT Scans
• PCT Scans
• Ultrasonido
• Rayos X
• Estudios del sueno
Todos los Centros de Diagnóstico requieren que los exámenes que se solicitan hayan sido previamente indicados por
un profesional de la salud con licencia que le autoriza a ejercer la práctica de la medicina en el estado de la Florida. La
indicación del procedimiento debe estar escrita en una receta médica o en su lugar en el formulario de solicitud establecida
para los procedimientos de Diagnósticos y firmada por el médico que la indica.
Todos los laboratorios cumplirán el procedimiento legal establecido de confidencialidad del paciente y para proteger este
derecho enviaran los resultados de sus exámenes a la oficina del doctor que lo indicó.
Diagnostic Radiology / Centro de Diagnóstico
Digital Medical Diagnostic
41 Tamiami Canal Rd
Miami Fl. 33166
Phone: (305) 269-0833
Fax: (305) 269-0851
Digital Mammography
Mamografía digital
por sólo $50.00
58
CT Imaging Inc.
395 West 10 Street, Suite 2
Hialeah Florida 33010
Phone: (305) 887-7562
Miami - Dade
Eiber Radiology.
49 West 49th Street.
Hialeah, Fl. 33012
Phone: (305) 557- 0330
Fax: (305) 556-5133
Miami - Dade
Bay Imaging Group.
1755 NE 127th Street.
North Miami FL 33181
Phone: (305) 891-1900
Virtual Imaging Service.
3320 Palm Avenue.
Hialeah, FL 33012
Phone: (305) 596-9992
Transportation Available
Universal Imaging of Florida.
14462 Commerce Way.
Phone: (305) 821-8585
Palmetto Open MRI
3146 Coral Way Ste 200
Miami, FL 33145
Phone: (305) 448-6841
Virtual Imaging.
(Sleep Studies / Estudio del Sueño)
Miami, Fl. 33173
Phone: (305) 596-9992
Fax: (305) 779-9096
Precio: $500.00
Virtual Imaging Service.
7101 SW 99 Avenue, Suite 106
Miami, FL 33173
Phone: (305) 596-9992
Systems Associate Inc.
(Neurological Diagnostic)
Home and Office Service
7374 SW 93 Ave, Suite 201
Miami, Florida 33173
Phone: (305) 270-7771
CMS Open MRI
9601 SW 40 St
Miami, FL 33165
Phone: (305) 227-2500
South Florida Perinatal Medicine.
6200 Sunset Drive, Suite 301
Miami, FL 33143
Phone: (305) 669-9521
(Llamar a Customer Service
para otras seis localizaciones)
Virtual imaging
692 N. Homestead Blvd, Ste 106
Homestead, FL 33030
Phone: (305) 596-9992
LifeStream Mobile.
9745 Sunset Drive, Suite 201
Miami, FL 33173
Phone: (305) 264-2021
Servicios móbiles a domicilio u
oficinas médicas.
Ultrasonido
Cargo por visita: $15.00
Diagnostic Professional, Inc.
7301 NW 4th Street #107
Phone: (954) 449-7023
Fax: (954) 449-7027
Diagnostic Professional, Inc. 1799 West Oakland Park Blvd 105
Ft Lauderdale Fl. 33311
Phone: (954) 777-3466
Fax: (954) 777-3510
6808 N. State Road 7
Coconut Creek, Fl. 33073
Phone: (954) 570-5560
Fax: (954) 571- 5240
Broward Pet Imaging Center
4850 W. Oakland Park Blvd Suite 1A
Lauderdale Lakes, FL 33313
Phone: (954) 735-6330
Broward
10950 Pines Boulevard
Phone: (954) 430-2044
Fax: (954) 430-2055
59
A1 Imaging Centers, LLC -- Florida Locations (MRI Only) (MRI solamente)
60
A1 Imaging of Boynton Beach
3795 Boynton Beach Blvd Ste. C
Boynton Beach, Fl. 33436
Phone: (561) 740-9305
Fax: (561) 740-9305
Services: Open MRI
A1 Imaging of Orange Park
1566 Kingsley ave
Orange Park, Fl. 32073
Phone: (904) 278-2128
Fax: (904) 278-2129
Services: Closed and Open MRI
A1 Imaging of Deerfield
1890 W. Hillsboro Blvd.
Phone: (954) 429-8381
Fax: (954) 429-2705
Services: Open MRI
A1 Imaging of Ft. Lauderdale
5100 N federal Hwy, Ste 102
Ft. Lauderdale, Fl. 33308
Phone: (954) 202-3400
Fax: (954) 202-3448
Services: Open MRI
A1 Imaging of Pembroke Pines
8384 Pines Blvd
Phone: (954) 450-4020
Fax: (954) 432-8674
Services: Open MRI
A1 Imaging of Orlando
500 N Semoran Blvd., Ste 103
Orlando, Fl. 32807
Phone: (407) 275-6072
Fax: (407) 275-7301
Services: Open MRI
A1 Imaging of Ocoee
9450 W. Colonial Dr. Ste 12
Ocoee, Fl. 34761
Phone: (407) 822-0999
Fax: (407) 822-0990
Services: Open MRI
A1 Imaging of St. Augustine
200 S. Park Blvd.,Ste 210
St. Augustine, Fl. 32086
Phone: (904) 819-0920
Fax: (904) 819-0299
Services: Open MRI
A1 Imaging of West Palm Beach
1117 N. Olive Ave #101
West Palm Beach, Fl. 33401
Phone: (561) 651-7410
Fax: (561) 651-7417
Services: Open MRI
A1 Imaging of Plantation
150 N. University Dr. Ste 110
Phone: (954) 423-3674
Fax: (954) 916-0674
A1 Imaging of Mandarin
3753 Cardinal Point Dr.
Jacksonville, Fl. 32223
Phone: (904) 636-5674
Fax: (904) 448-4674
Services: Open MRI
A1 Imaging of Cape Coral
1003 Del Prado Blvd., Unit 102
cape Coral, Fl. 33990
Phone: (239) 573-6333
Fax: (239) 573-8674
Services: Open MRI
A1 Imaging of Kissimmee
810 North John Young Pkwy
Kissimmee, Fl. 34741
Phone: (407) 847-6745
Fax: (407) 847-8749
Services: Open MRI
A1 Imaging of Ocala
301 SE 17th St., Unit 102
Ocala, Fl. 34471
Phone: (352) 622-7459
Fax: (352) 622-9238
Services: Open MRI
A1 Imaging of Aventura
20880 W. Dixie Hwy, Suite 111/106
Phone: (305) 933-9565
Fax: (305) 933-8105
61
62
62
63
64
64
PRECIOS DE MEDICINA PERINATAL
Ultrasound
76801
76802
76805
76810
76811
76812
76813
76814
76815
76816
76817
76818
76819
76820
76821
76830
76856
76945
76946
SFPM Rates
1st Tri<14 wks New
1st Tri each Add Gest w/76801
Complete Routine
Comp Routine each Add Gestw/76805
>1 Tri HighRisk Detailed Targ - New
>1 Tri HgRk Detailed Tgt eachAdd Gest w/76811
OB/US Nuchal Measurement I Gest
Nuchal Measurement each additional Gestation
Limited-quick look @1or more elements
Follow Up (re-eva org susp abnormal)
OB Transvag (use in addition to transadom code)
BPP w/NST
BPP w/out NST
Doppler UA
Doppler CA
Vag. Ultra (non-obstetrical purposes)
Pelvic TR
CVS Guidance
Amnio Guidance
Member Fees
$240.00
$140.00
$245.00
$230.00
$415.00
$265.00
$230.00
$155.00
$175.00
$160.00
$230.00
$245.00
$230.00
$180.00
$225.00
$265.00
$225.00
$245.00
$230.00
59000
Amnio
$300.00
59015
CVS
$370.00
99211
Minor 5 minute established
$70.00
99241
Minor 15 minute
$125.00
99242
Low 30 Min
$160.00
99243
Moderate 40 Min
$210.00
99244
Mod High 60 Min
$265.00
99251
Inpatient Consult 20 Min
$115.00
99252
$175.00
99254
$280.00
59025
NST
$125.00
AMNIO
Includes Counceling, U/S, Guidance, Amnio
TWINS
$1,645.00
Includes Counceling,U/S, Guidance, CVS
TWINS
$1,665.00
CVS
$2,700.00
1ST TRIMESTER
Includes Counceling, 1st Trimester U/S, Labs
$2,775.00
$805.00
SCREENING
& Nuchal Translucency
TWINS
$1,100.00
INTEGRATED
Includes Counceling, 1st Trimester U/S, NT
$900.00
SCREENING
1st & 2nd Labs Included
TWINS
$1,195.00
SEQUENTIAL
Includes Counceling, 1st Trimester U/S, NT
$825.00
SCREENING
and first part Labs
TWINS
$1,120.00
65
ANCILLARY SERVICES / SERVICIOS AUXILIARES
DURABLE MEDICAL SUPPLIES
Services Details
When ordering medical equipment you must have a valid prescription signed by a licensed and authorized healthcare
professional in the State of Florida indicating the supplies or equipment needed. You must present your Med Plan
membership card with a picture ID so that your eligibility can be verified before your supplies are delivered. In order to
receive the exclusive pricing offered to Med Plan members at contracted provider locations your monthly membership fee
needs to be current.
The durable medical supply offered to Med/Plan members are:
•
•
•
•
Wheel Chairs
Walkers
Hospital Beds
Oxygen Concentrators
Offered 80% savings off of Providers Usual and Customary Fees.
Unlimited Access to all Durable Medical Services.
SERVICIOS DE EQUIPOS MEDICOS
Al pedir suministro de algún equipo médico debe tener una receta de prescripción válida firmada por su Doctor donde se
indique los suministros y equipos que necesita. Usted tendrá que presentar su tarjeta de miembro conjuntamente con una
identificación (ID) con foto para que su elegibilidad pueda ser verificada en el momento y pueda beneficiarse de las tarifas
preferenciales exclusivas que aplican únicamente a los miembros de MedPlan.
Entre los equipos medicos duraderos ofrecidos por Med/Plan estan:
•
•
•
•
Sillas de ruedas
Andadores
Camas de hospital
Concentradores de oxígeno
Estos servicios ofrecen un ahorro del 80% de descuento de los proveedores habituales y tarifas habituales.
Acceso ilimitado a todos los servicios de equipos medicos duraderos.
66
ORTHOPEDIC SUPPLIES / SUPLEMENTOS ORTOPEDICOS
Podortis Corp.
(Orthopedic Supplies)
4701 SW 8 St
Miami, FL 33134
Phone: (305) 446-2995
Fax: (305) 446-2996
PROSTHETIC ORTHOTIC FEES
L CODE
DESCRIPTION
Member
Fees
$100.80
A5500 X 2
OFF THE SHELF DIAB SHOE / ZAPATOS PARA DIABETICOS
A5512 X 2
DIAB MULTIDENSITY INSERTS / SOPORTES DE DIAB PREFAB
$38.74
A5513 X 2
DIAB MULTIDENSITY CUSTOM INSERTS / SOPORTES DE DIABETICO
$57.82
L3002 X 2
DIAB PLASTAZOTE CUSTOM INSERT / SOPORTES ACOMODATIVOS DE DIABETICOS
$155.20
L5000 X 1
INSERT FOR MISSING TOES / SOPORTE PARA DEDOS AMPUTADOS
$129.96
A6530 X 2
BELOW KNEE 18-30 COMRESSION STOCKING / MEDIAS PARA CIRCULACION A LA RODILLA 18-30
$55.87
A6531 X 2
$62.30
A6532 X 2
$115.82
A6533 X 2
THIGH LENGTH 18-30 COMPRESSION STOCKING / MEDIAS PARA LA CIRCULACION AL MUSLO 18-30
$73.33
A6534 X 2
$73.33
A6535 X 2
$77.40
A6539 X 2
WAIST LENGTH 18-30 COMPRESSION STOCKING / MEDIAS PARA CIRCULACION PANTY 18-30 MMHG
$200.79
A6540 X 2
$200.79
A6541 X 2
$211.95
L4350 X 1
AIR CAST PREFAB
$57.13
L4360 X 1
PNEUMATIC CAM WALKER PREFAB / BOTA DE MARCHA INMOVILIZADORA-NEUMATICA
$166.30
L4386 X 1
REGULAR CAM WALKER PREFAB / BOTA DE MARCHA INMOVILIZADORA CORTA O LARGA
$107.73
L4396 X 1
NIGTH SPLINT PREFAB
$94.62
L3000 X 2
UCBL CUSTOM FOOT ORTHOTIC / SOPORTE A LA MEDIDA TIPO UCB
$337.56
L3010 X 2
CUSTOM LONGITUDINAL ARCH SUPPORT / SOPORTE ARCO LONGITUDINAL
$155.20
L3020 X 2
CUSTOM METATARSAL ARCH SUPPORT / SOPORTE LONGITUDINAL METATARSIANO
$155.20
L1902 X 2
AFO GAUNLET PREFAB / AFO, APARATO PARA EL PIE TIPO GUANTE PREFAB
$39.29
L1906 X 1
AFO FOR PPTD PREFAB / AFO, PARA ESTABILIZAR EL PIE PREFAB
$83.91
L1930 X 1
AFO PLASTIC PREFAB
$79.06
L1940 X 1
AFO CUSTOM FAB / AFO A LA MEDIDA
$215.34
L1960 X 1
AFO POSTERIOR SOLID ANKLE CUSTOM / AFO A LA MEDIDA CON REFUERZO EN EL TOBILLO
$251.23
L8000 X 1
MASTECTOMIE BRAS / AJUSTADOR DE MASTECTOMIA
$26.13
L8020 X 1
BREAST PROSTHESIS MASTECTOMIE FORM FOAM / PROTESIS DE SENO DE FOAM
$128.65
L8030 X 1
BREAST PROSTHESIS SILICONE OR EQUAL / PROTESIS DE SENO EN SILICONA
$139.15
L1810 X 1
KO, ELASTIC WITH JOINTS PREFAB / RODILLERA SENCILLA PREFAB
$79.06
L1832 X 1
KO, ADJUSTABLE KNEE JOINTS, RIGID SUPPORT, PREFAB /RODILLERA CON ARTICULACION PREFAB
$531.35
L1845 X 1
KO, DOUBLE UPRIGHT, THIGH AND CALF, PREFAB / RODILLERA CON AJUSTABLE ARTICULACION FLEXION Y EXTENSION
$543.69
L1847 X 1
KO, DOUBLE UPRIGHT, AIR, PREFAB / RODILLERA CON AIRE, PREFAB
$348.25
67
PROSTHETIC ORTHOTIC FEES
L CODE
DESCRIPTION
L0120 X 1
CERVICAL COLLAR, FOAM, PREFAB
L0190 X 1
CERVICAL COLLAR TAYLOR TYPES / COLLAR CERVICAL TIPO TAYLOR
L0700 X 1
CTLSO, MINERVA TYPE, CUSTOM / CTLSO, TIPO MINERVA, A LA MEDIDA
$1,406.50
L0710 X 1
CTLSO, ANTERIOR/POSTERIOR CONTROL MINERVA TYPE, CUSTOM
$1,552.00
L1300 X 1
SCOLIOSIS JACKET CUSTOM / SCOLIOSIS JACKET A LA MEDIDA
$727.50
L0462 X 1
TLSO, TRIPLANAR, 3 PLASTIC SHELLS / TLSO, TRIPLANAR, 3 MODULOS PLASTICOS
$518.99
$281.30
L0464 X 1
TLSO, MODULAR SEGMENTED, 4 PLASTIC SHELLS / TLSO MODULAR SEGMENTADO, 4 PLASTICOS
$518.99
L0482 X 1
TLSO,TRIPLANAR CONTROL, ONE PIECE RIGID PLASTIC SHELL / TLSO, CONTROL TRIPLANAR UNA PIEZA RIGIDA PLASTICA
$933.85
L0486 X 1
TLSO,TRIPLANAR CONTROL, TWO PIECES RIGID PLASTIC SHELL / TLSO, CONTROL TRIPLANAR, 2 PIEZAS RIGIDAS EN PLASTICO
L0488 X 1
TLSO,TRIPLANAR CONTROL, ONE PIECE RIGID PLASTIC SHELL / TLSO, CONTROL TRIPLANAR UNA PIEZA RIGIDA PLASTICA
$227.53
L0627 X 1
LSO, SAGITAL CONTROL, RIGID PANELS / LSO, CONTROL SAGITAL PANELES RIGIDOS
$299.45
L0631 X 1
LSO, SAGITAL CONTROL, POSTERIOR EXTENDS, REDUCE LOAD
$747.83
L1686 X 1
HIP ORTHIOSIS, ABDUCTION CONTROL, PREFAB / APARATO DE CADERA, CONTROLA ABDUCTION
$539.08
L2112 X 1
AFO TIBIAL FRACTURE ORTHOSIS, SOFT, PREFAB / AFO, APARATO PARA FRACTURA TIBIAL SUAVE
$331.74
L2114 X 1
AFO TIBIAL FRACTURE ORTHOSIS, SEMI RIGID, PREFAB / APARATO PARA FRACTURA TIBIAL SEMIRIGIDO, PREFAB
$465.60
$1021.88
L2116 X 1
AFO TIBIAL FRACTURE ORTHOSIS, RIGID, PREFAB / APARATO PARA FRACTURA TIBIAL RIGIDO
$465.60
L2128 X 1
KAFO FEMORAL FRACTURE CAST ORTHOSIS, CUSTOM / KAFO, APARATO PARA FRACTURA FEMORAL A LA MEDIDA
$976.31
L2134 X 1
KAFO FEMORAL FRACTURE CAST ORTHOSIS SEMIRIGID, PREFAB / APARATO PARA FRACTURA FEMORAL, SEMIRIGIDO, PREFAB
$439.11
L3670 X 1
SO, (CANVAS AND WEBBING TYPE) PREFAB / CABESTRILLO DE BRAZO, PREFAB
$55.29
L3760 X 1
ELBOW ORTHOSIS, WITH ADJUSTABLE POSITION, PREFAB / APARATO DE CODO AJUSTABLE
$268.57
L3908 X 1
WRIST HAND ORTHOSIS PREFAB / MUNEQUERA PREFAB
$17.46
L3931 X 1
WRIST HAND FINGER ORTHOSIS PREFAB / MUNEQUERA CON DEDO GORDO PREFAB
$128.55
L3980 X 1
HUMERAL FRACTURE ORTHOSIS PREFAB / APARATO DE FRACTURA DE HUMERUS PREFAB
$121.25
L3982 X 1
RADIUS/ULNAR FRACTURE ORTHOSIS PREFAB / APARATO DE FRACTURA DE RADIO, ULNAR PREFAB
$218.25
$244.44
L3984 X 1
WRIST FRACTURE ORTHOSIS PREFAB / APARATO DE FRACTURA DE MUNECA, PREFAB
L3995 X 1
ADDIT FRACTURE SOCK OR EQUAL
L8300 X 1
SINGLE ABDOMINAL BINDER / FAJA ABDOMINAL SENCILLA
L8310 X 1
BILATERAL ABDOMINAL BINDER / FAJA ABDOMINAL BILATERAL
HEARING AIDS / SUPLEMENTOS AUDITIVOS
Belgica Mock
(Hearing Specialist)
(Crystal Clear Hearing)
11342 Quail Roost Drive
Miami, Fl. 33157
Phone: (305) 235-4035
68
Member
Fees
$12.13
$11.64
$59.90
$161.26
69
Home Health Service
Miami - Dade / Broward
ALC Home Health.
Home Health Services
(Physical Therapy)
13275 SW 124 St. Miami FL 33186
Phone: (305) 828-5310
Home Health Aid: $ 15.00 per Visit
RN: $ 29.00 per Visit
Physical Therapy: $ 80.00 per Visit
Occupational Therapy: $ 80.00 per Visit
Speech Therapy: $ 95.00 per Visit
HHA or CAN Visit: $15.00 per visit
C&O Home Healthcare Corp
(Home Health Services)
(Physical Therapy)
1100 West 29th street Suite H
Hialeah FL 33012
Tel: (305) 360-4104
Skilled Nursing: $ 45.00 per Visit
Home Health Care.
Preferred Home Health Agency, Inc.
13903 NW 67 Avenue, Suite 420
Phone: (305) 231-4250
Skilled Nursing: $ 45.00 per Visit
Capital Health Services Inc.
(Home Health Services)
Miami, Fl. 33144
Tel: (305) 261-3831
License Practice Nurse per Visit
$27.00
Home Health AIDE per Visit $18.00
Physical Therapy
Holistic Nursing Care Agency
Home Health Services
7400 NW 7 St. Miami Fl. 33126
Phone: 305-265-9618
Skilled Nursing: $30.00
Home health Aid: $15.00
Physical Therapy: $80.00
Occupational Therapy: $80.00
Speech Therapy: $80.00
HHA or CAN: $15.00
Miami - Dade
Claudius Galen Therapy Center
(Physical and Speech Therapy)
489 E Hialeah Drive #10
Hialeah, Fl. 33010
Phone: (786) 953-6302
Language: English/Spanish
Davila Medical Center
(Family Medicine)
782 NW 42 Av. Ste 318
Miami, Fl. 33126
Phone: (305) 441-2760
Fax: (305) 441-2760
Touch For Healing Rehab. Center, Inc
(Physical Therapy)
7200 NW 7 St. Ste 200
Miami, Fl. 33126
Phone: (305) 764-3629
Fax: (305) 764-3505
Continental Rehabilitation Center Inc.
(Physical Therapy)
Miami, Fl. 33144
Tel: (305) 264-6688
Laskrsin Rehabilitation Center
(Physical Therapy)
11890 SW 8 St.Suite 407/408
Miami Fl. 33184
Phone: (305) 228-2842
Sunrise Relax Health Care Corp.
(Physical Therapy)
636 SW 109 avenue
Miami Florida 33174
Phone: (305) 221-8500
ABC Medical Group
(Physical Therapy)
1393 SW 1st St.Suite 320
Miami Florida 33135
Phone: (305) 644-0977
The New City Medical Center
(Physical Therapy)
4118 W 12 Ave
Miami Fl. 33012
Phone: (305) 824-8787
70
CODES
97010
97010
97012
97014
97018
97026
97032
97034
97035
97039
97110
97112
97124
97139
97140
97140
E0217
E0218
97535
THERAPY SERVICES
SERVICIOS DE TERAPIA
Hot / Cold Pack
Ice / Cryo therapy
Mechanical Traction
E.M.S
Paraffin Bath
Infrared
E.M.S Attended
Contrast Bath
Ultrasound
Vibratory Massage
Therapeutic Exercise
Neuromuscular Re-Education
Massage
Hydro massage
Manual Therapy
Manual Traction
Water Circulating Cold
Water Circulating Hot
Self / Home Care
Member Fees
$12.00
$12.00
$33.34
$26.50
$18.40
$13.20
$34.16
$32.00
$27.50
$17.50
$57.00
$63.00
$47.00
$17.00
$65.00
$65.00
$91.00
$91.00
$41.00
71
DIABETES SUPPLY SERVICES
DIABETES SUPPLY (CLEVER CHOICE PLUS SYSTEM)
Diabetes Supply (Clever Choice Plus)
Glucose Meter (Glucometro)
Test Strips
$2.50
$2.50
$14.99
Lancing Device
Box of 10 Lancets
Box of 50 strips
Services Details
Free Home Delivery.
Unlimited Access to all Diabetic Supplies.
When ordering diabetic supplies you must have a valid prescription signed by a licensed and authorized healthcare
professional in the State of Florida indicating the supplies needed.
Note: Free Delivery service is provided as a courtesy to Med Plan members but is subject to the Diabetes Medical Supply
provider ability and the distance to the Members pick up point. Please call the provider for more details.
SUPLEMENTOS PARA LA DIABETES
Entrega gratis a domicilio.
Acceso ilimitado de todos los suministros para diabéticos.
Al pedir suministros para Diabetes o algún equipo médico debe tener una receta de prescripción válida firmada por su
Doctor donde se indique los suministros y equipos que necesita.
Nota: El servicio a domicilio es gratuito y se ofrece como una cortesía para los miembros de Med Plan, pero está sujeto a
la capacidad del proveedor de los suministros y la distancia donde se encuentre el miembro como punto de entrega. Por
favor, llame al proveedor para obtener más detalles.
Our Provider / Nuestro Proveedor:
DIRECT MEDS OF FLORIDA
Telf: 954-454-8118
Fax: 954-454-9898
Free Shipping Anywhere in the United States
72
PHARMACY SERVICES
Services Details
•
•
•
•
•
•
Exclusive Pharmacy Services in Miami Dade County with Navarro Pharmacy.
Rx Savings Plus program available for out of State Pharmacy services.
400 Medication Formulary of the most frequently used medications for $9.99 for 100 pills or tablets.
Over 65,000 medications offered at Florida MAC plus $3.73 for Dispensing.
Prescription Assistance Program available for most brand medications.
Home Delivery Program available to all Med Plan members.
When visiting your Pharmacy to fill a prescription you must have a valid prescription signed by a licensed and authorized
healthcare professional in the State of Florida.
Med Plans “Prescription Assistance Program” are services provided directly by the pharmaceutical medi cation manufacturer.
These programs are designed to help pay for the high cost of Brand medications that our members may not be able to
afford. These “PAP” programs can greatly reduce the cost of the medications or in some case the member can get their
medication completely free. Med Plan will help its members identify which programs are available and assist them in filling
the necessary documents as part of our commitment to our members.
Rx SavingsPlus Program is offered as an added value service which provides Med Plan members access to pharmacy
services outside of Med Plans Florida coverage area. Your membership kit contains a brochure with your “Rx SavingsPlus”
card inside. You can use this card outside of Florida at any Pharmacy as listed on the back of the brochure. Please note
that pricing for medications under this program differs from the Florida Pharmacy providers. For medication pricing under
this program you can go to www.medplan.rxsavingsplus.com
to get specific cost. This service is only to be used if the member is outside the Med Plans Florida coverage area.
SERVICIOS DE FARMACIA
•
•
•
•
•
•
Servicios exclusivos en el condado Miami Dade brindados por Navarro Pharmacy
Programa Rx Savings Plus disponible para los servicios de Farmacia fuera de la Florida.
400 medicamentos genéricos usados con más frecuencia a un costo de $ 9.99 por 100 pastillas.
Más de 65.000 medicamentos se ofrecen en Florida MAC además de $3.73 para la distribución.
Programa de asistencia de receta médica para todos los medicamentos (no genéricos).
Programa de entrega de medicamentos a domicilio para todos los miembros de Med Plan.
Para obtener algún medicamento pre-escrito por su Doctor, deberá presentar en la farmacia participante una receta válida
firmada por un medico licenciado y autorizado en el Estado de la Florida.
El Programa de Asistencia de receta médica es un servicio prestado directamente por el fabricante de medicamentos
farmacéuticos. Este programa está diseñado para ayudar a pagar el alto costo de los medicamentos no genéricos que
nuestros miembros no pueden pagar. Este programa puede reducir considerablemente el costo de los medicamentos o
en algunos casos el miembro puede obtener sus medicamentos completamente gratis. Med Plan ayudará a sus miembros
a identificar los programas que están disponibles y los ayudará a completar los documentos necesarios como parte del
compromiso con sus miembros.
Rx Savings Plus se ofrece como un servicio de valor añadido que provee a los miembros el acceso a los servicios de
farmacia fuera de área de la Florida. Su paquete de membrecía contiene un folleto en su interior “Rx SavingsPlus”. Usted
puede utilizar esta tarjeta fuera de la Florida en cualquier farmacia como aparece en el reverso del folleto. Tenga en cuenta
que los precios de los medicamentos dentro de este programa se diferencian de los proveedores de farmacia locales de la
Florida.
73
Pharmacy / Farmacia
Miami - Dade
Navarro Discount Pharmacy.
(North Miami Lakes)
6410 NW 186 St.
Hialeah FL 33015
Phone: (305) 825-3386
Fax: (786) 621-1097
Mon - Sat: 8:00 Am To 10:00 Pm
Sun: 9:00 Am To 7:00 Pm
(Miami Lakes)
16801 NW 67 Ave.
Miami FL 33015
Phone: (305) 822-9522
Fax: (305) 822-9775
Mon - Sun: 6:00 Am To 12:00 Am
(Okeechobee)
2399 W 52 St.
Hialeah FL 33016
Phone: (305) 822-3385
Fax: (786) 621-0866
Sun: 9:00 Am To 7:00 Pm
(East Hialeah)
366 E 4 Ave.
Hialeah FL 33010
Phone: (305) 883-0852
Fax: (786) 621-0861
Sun: 9:00 Am To 7:00 Pm
(Hialeah Palm)
3915 Palm Ave.
Hialeah FL 33012
Phone: (305) 822-2210
Fax: (786) 621-7863
Sun: 9:00 Am To 7:00 Pm
(West Hialeah)
3960 W 12 Ave.
Hialeah FL 33012
Phone: (305) 556-3117
Fax: (786) 621-0860
Sun: 9:00 Am To 7:00 Pm
(Hialeah)
775 W 49 St. Suite 1
Hialeah FL 33012
Phone: (305) 823-0823
Fax: (305) 823-0030
(Hialeah Gardens)
3141 W 76 St Suite 5
Hialeah FL 33018
Phone: (305) 231-8200
Fax: (305) 557-4707
Sun: 9:00 Am To 7:00 Pm
(Flamingo Plaza)
4410 West 16 Ave.
Hialeah FL 33012
Phone: (305) 556-8585
Fax: (305) 824-9601
Sun: 9:00 Am To 7:00 Pm
13250 Biscayne Blv.
North Miami , Fl. 33181
Phone: (305) 891-3551
Fax: (305) 891-3902
Sun: 9:00 Am To 7:00 Pm
(Doral)
11402 NW 41 St # 127.
Doral FL 33178
Phone: (305) 471-8184
Fax: (305) 471-8189
Sun: 9:00 Am To 7:00 Pm
(Miracle Mile)
93 Miracle Mile,
Coral Gables FL 33134
Phone: (305) 445-1059
Sun: 9:00 Am To 7:00 Pm
(Ponce De Leon)
3949 SW 8 St.,
Miami FL 33134
Phone: (305) 444-7530
Fax: (305) 442-2805
(Sunset)
10720 SW 72 St.,
Miami FL 33173
Phone: (305) 271-9909
Fax: (305) 412-1851
24 Hrs
(Little Havana)
1243 SW 8th St.
Miami FL 33135
Phone: (305) 854-8544
Fax: (305) 854-6463
Sun: 9:00 Am To 7:00 Pm
74
Pharmacy / Farmacia
Miami - Dade
(Flagler)
5252 West Flagler St.
Miami FL 33134
Phone: (305) 442-9946
Fax: (305) 442-7320
Sun: 9:00 Am To 10:00 Pm
(Sweetwater)
Miami FL 33174
Phone: (305) 223-3555
Fax: (305) 485-8037
Sun: 9:00 Am To 7:00 Pm
(FIU)
12000 SW 8th St.
Miami FL 33184
Phone: (305) 225-8900
Fax: (305) 485-9009
(Hammocks)
14665 SW 104th St.
Miami FL 33186
Phone: (305) 752-0600
Fax: (305) 752-4272
Sun: 10:00 Am To 7:00 Pm
(Country Walk)
13796 SW 152th St.
Miami FL 33177
Phone: (305) 256-9800
Fax: (786) 249-0014
Sun: 10:00 Am To 7:00 Pm
(Westchester)
9686 SW 24th St.
Miami FL 33165
Phone: (305) 225-9307
Fax: (786) 621-0859
Sun: 9:00 Am To 7:00 Pm
(Coral Way)
11865 SW 26th St.
Miami FL 33175
Phone: (305) 227-0023
Fax: (305) 227-3021
Sun: 9:00 Am To 7:00 Pm
(West Sunset)
15000 SW 72th St.
Miami FL 33193
Phone: (305) 387-1300
Fax: 305) 388-2310
Sun: 9:00 Am To 7:00 Pm
(East Flagler)
Miami FL 33135
Phone: (305) 643-9762
Fax: (786) 621-5810
Sun: 9:00 Am To 7:00 Pm
(Sunny Isles)
18500 Collins Ave.
Sunny Isles FL 33160
Phone: (305) 792-4099
Fax: (305) 792-4492
Sun: 9:00 Am To 7:00 Pm
(North Shore)
631 71th St.
Miami Beach FL 33141
Phone: (305) 865-0075
Fax: (305) 865-1886
(West Bird Rd)
14491 SW 42 St.
Miami FL 33175
Phone: (305) 229-1044
Fax: (305) 229-9039
Sun: 9:00 Am To 7:00 Pm
(Galloway)
8760 SW 40 St.
Miami FL 33165
Phone: (305) 552-1498
Fax: (305) 559-3193
Sun: 9:00 Am To 7:00 Pm
Presidente Pharmacy.
10845 SW 40th St
Miami, Fl. 33165
Phone: (305) 485-8888
President Pharmacy
Miami, Fl. 33157
Phone: (305) 235-8244
Cardenas Pharmacy.
2741 Coral Way.
Miami, Fl. 33145
Phone: (305) 529-0003
Fax: (305) 529-1022
My Pharmacy of Homestead.
806 N. Krome Ave.
Phone: (305) 247-6949
Fax: (305) 247-6072
Pro Pharmacy
Miami, Fl. 33157
Phone: (305) 971-3388
Las Villas Pharmacy
716 W 29th ST
Hialeah, Fl. 33012
Phone: (305) 883-7476
Redondo Pharmacy Discount
19533 N.W 57 Ave.
Miami, Fl. 33055
Phone: (305) 625-0225
75
Pharmacy / Farmacia
Broward
Direct Meds of Florida
800 E. Hallandale Beach Blvd
Hallandale Beach FL 33009
Tel: (954) 454-8118
Fax: (954) 454-9898
Refer to Drug Pricing Fee Schedule
Home Delivery Service
Free Mail Order Delivery Service
Pharmacy / Farmacia
Cape Coral Express Pharmacy
4419 Del Prado Blvd North
Cape Coral FL 33904
Tel: (239) 574-8846
Fax: (239) 574-7080
76
Lee / Cape Coral
St. Jude Pharmacy
1202 N.E Pine Island Road Ste 1V
Cape Coral FL 33909
Tel: (239) 673-7777
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primary physicians / medicos primarios

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