Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › PR › MAYAGUEZ › WALMART #2067

WALMART #2067

NPI: 1003942467 · MAYAGUEZ, PR 00680 · Eyewear Supplier · NPI assigned 02/27/2007

$98K
Total Medicaid Paid
4,694
Total Claims
2,269
Beneficiaries
5
Codes Billed
2018-01
First Month
2018-10
Last Month

Provider Details

Authorized OfficialHERNANDEZ, JORGE (DIRECTOR OF SPECIALTY DIVISION)
NPI Enumeration Date02/27/2007

Related Entities

Other providers sharing the same authorized official: HERNANDEZ, JORGE

ProviderCityStateTotal Paid
GWINNETT PHYSICIAN GROUP, LLC LAWRENCEVILLE GA $8.28M
NORTH ATLANTA PROFESSIONAL SERVICES LLC ATLANTA GA $849K
GEORGIA SURGICAL PROFESSIONAL SERVICES, LLC ATLANTA GA $709K
WALMART #2501 BAYAMON PR $59K
WALMART #2085 ISABELA PR $37K
PULMONARY MEDICINE ASSOCIATES, P.A. OCOEE FL $4K
NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC ATLANTA GA $3K
JORGE L HERNANDEZ MD PA BRADENTON FL $3K
WALMART #1854 HATILLO PR $999.90
NORTHSIDE HOSPITAL, INC. ATLANTA GA $953.17

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 4,694 $98K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 1,989 956 $67K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 1,303 645 $21K
V2750 Anti-reflective coating, per lens 1,049 501 $9K
V2744 Tint, photochromatic, per lens 198 96 $1K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 155 71 $841.00