Supplier
Farmacia San Jose LLC
Farmacia San Jose LLC was paid $12K by Medicaid between Feb 2018 and Dec 2021, across 6 billing codes. Its largest line is 90670, — 29% of everything it billed.
33Billing provider infoFARMACIA SAN JOSE LLC
LARES, PR 00669
LARES, PR 00669
33aNPI1699763326assigned 10/06/2005
33bProvider typeCommunity/Retail Pharmacy
28Total paid$12K
24GClaims1,363
24DCodes billed6
24AFirst – last monthFeb 2018 – Dec 2021
Compared with peers
Next to other Community/Retail Pharmacy providers in Puerto Rico
Rank by total paid#5 of 23
Median peer was paid$3K
This provider vs. median4.4×
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 | 804 | $6K | |
| 2019 | 384 | $5K | |
| 2020 | 110 | $284.15 | |
| 2021 | 65 | $272.88 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90670 | 29% | 42 | 37 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 28% | 620 | 491 | $3K |
| 90686 | 24% | 451 | 401 | $3K | |
| 90732 | 13% | 60 | 56 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 6.0% | 154 | 120 | $715.78 |
| 90715 | <1% | 36 | 36 | $12.00 |
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 officialJIMENEZ, FRANCISCO (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Latino Health Services Medical Group INC | Santa Ana, CA | $6.43M |
| Azul Medical Clinic INC | Bell Gardens, CA | $6K |
| Bear Valley Clinica Familiar, INC | Victorville, CA | $5K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.