Walmart

Walmart was paid $28K by Medicaid between Jan 2018 and Oct 2018, across 5 billing codes. Its largest line is V2020, Frames, purchases — 66% of everything it billed.

33Billing provider infoWALMART
TOA BAJA, PR 00949

33aNPI1083964043assigned 09/17/2012

33bProvider typeEyewear Supplier

28Total paid$28K

24GClaims1,322

24DCodes billed5

24AFirst – last monthJan 2018 – Oct 2018

Compared with peers

Next to other Eyewear Supplier providers in Puerto Rico

Rank by total paid#16 of 39

Median peer was paid$20K

This provider vs. median1.4×

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
2018	1,322	$28K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
V2020	Frames, purchases	66%	559	306	$19K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	20%	382	208	$6K
V2750	Anti-reflective coating, per lens	11%	306	154	$3K
V2744	Tint, photochromatic, per lens	1.5%	27	16	$410.00
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	<1%	48	21	$213.00

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 officialSERRANO, KYLMARIE (HEALTH & WELLNESS REGIONAL DIRECTOR)