Supplier
Walmart #1854
Walmart #1854 was paid $999.90 by Medicaid between Oct 2023 and Oct 2023, across 1 billing code. Its largest line is V2103, Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens — 100% of everything it billed.
33Billing provider infoWALMART #1854
HATILLO, PR 00659
HATILLO, PR 00659
33aNPI1023144474assigned 02/27/2007
33bProvider typeEyewear Supplier
28Total paid$999.90
24GClaims26
24DCodes billed1
24AFirst – last monthOct 2023 – Oct 2023
Compared with peers
Next to other Eyewear Supplier providers in Puerto Rico
Rank by total paid#37 of 39
Median peer was paid$20K
This provider vs. median0.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 26 | $999.90 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 100% | 26 | 13 | $999.90 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialHERNANDEZ, JORGE (DIRECTOR OF SPECIALTY DIVISIONS)
| Provider | Location | Paid |
|---|---|---|
| Gwinnett Physician Group, LLC | Lawrenceville, GA | $8.28M |
| North Atlanta Professional Services LLC | Atlanta, GA | $849K |
| Georgia Surgical Professional Services, LLC | Atlanta, GA | $709K |
| Walmart #2067 | Mayaguez, PR | $98K |
| Walmart #2501 | Bayamon, PR | $59K |
| Walmart #2085 | Isabela, PR | $37K |
| Pulmonary Medicine Associates, P.A. | Ocoee, FL | $4K |
| NSH Cancer Institute Professional Services G, LLC | Atlanta, GA | $3K |
| Jorge L Hernandez MD PA | Bradenton, FL | $3K |
| Northside Hospital, INC. | Atlanta, GA | $953.17 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.