Medical Pharmacy and Lab

Medical Pharmacy and Lab was paid $2.60M by Medicaid between Jan 2018 and Dec 2024, across 17 billing codes. Its largest line is 96160, — 50% of everything it billed.

33Billing provider infoMEDICAL PHARMACY AND LAB
SAN JUAN, PR 00921

33aNPI1578772356assigned 05/21/2007

33bProvider typeExclusive Provider Organization

28Total paid$2.60M

24GClaims761,014

24DCodes billed17

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Exclusive Provider Organization providers in Puerto Rico

Rank by total paid#1 of 19

Median peer was paid$250K

This provider vs. median10×

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	98,671	$130K
2019	111,768	$441K
2020	70,111	$449K
2021	98,428	$442K
2022	107,278	$579K
2023	123,381	$400K
2024incomplete	151,377	$158K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
96160		50%	92,003	79,973	$1.29M
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	22%	463,040	357,986	$568K
A0130	Non-emergency transportation: wheelchair van	9.7%	8,192	429	$251K
99050		7.5%	59,632	50,821	$194K
A0110	Non-emergency transportation and bus, intra or inter state carrier	4.0%	5,672	353	$105K
99441		3.1%	99,429	82,759	$81K
S0215	Non-emergency transportation; mileage, per mile	2.8%	13,248	769	$72K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	1.1%	15,398	14,528	$29K
93000		<1%	3,688	3,482	$5K
99349		<1%	198	175	$183.80
99205	Prolong outpt/office vis	<1%	86	83	$47.00
99341		<1%	15	15	$40.58

5 more codes

99347		<1%	60	$40.00
99215	Doctor's office visit, returning patient (complex)	<1%	196	$35.00
99342		0%	76	$0.00
99442		0%	43	$0.00
99348		0%	38	$0.00

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 officialROBLEDO, MIGUEL (PRESIDENTE)