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NPI 1336123322 · Villalba, PR · Community/Retail Pharmacy
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Empresas Bonilla Colon Inc is a community/retail pharmacy provider located in Villalba, Puerto Rico. This profile covers 1 Medicare and 18 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Empresas Bonilla Colon Inc |
| Address | Carr 149 Km 56.7 |
| City | Villalba |
| State | PR |
| ZIP | 00766 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | December 2, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $190.3K |
| Medicare | $83.3K |
This provider bills to both Medicare and Medicaid but generates more revenue from Medicaid than Medicare: total Medicaid revenue is $190.3K versus total Medicare revenue of $83.3K. The presence of meaningful revenue on both payers indicates a mixed-payer retail pharmacy operation rather than a single-payer specialty clinic or exclusively Medicaid-serving entity.
Medicare revenue is entirely concentrated in a single code: K1034 accounts for 100.0% of this provider's Medicare revenue, representing $83.3K across 6.9K claims with an average paid/claim of $12. The code description (provision of nonprescription self-administered COVID-19 tests) indicates the provider's Medicare-facing activity is focused on distributing or provisioning COVID self-test kits rather than clinical evaluation services; K1034 ranks #411 of 30143 providers nationally (99th percentile) in the provided comparison, although that volume is labeled "typical, unremarkable" for the code.
The provider's Medicaid revenue is more diversified but still concentrated: the top three Medicaid codes (0002A at $46K, 90670 at $41.8K, and 0001A at $33.6K) together account for 63.7% of total Medicaid revenue. One of those top codes, 90670, is a pneumococcal vaccine product, which confirms immunization services are a material component of the Medicaid business line.
Several Medicaid codes show above-average in-state standing for immunization-related services: 90732 (pneumococcal polysaccharide vaccine) ranks #2 of 33 providers in-state at the 97th percentile and is labeled "notably above typical state volume," while 0002A and 0001A rank #15 of 161 (91th percentile) and #19 of 160 (89th percentile) respectively. These rankings indicate the provider is a comparatively prominent vaccinator in Puerto Rico for specific pneumococcal-related codes, even as other vaccine codes show more typical volumes.
There are extreme outlier signals in Medicaid administration claims that warrant attention: G0008 (influenza vaccine administration) has 894 claims with $0 avg paid/claim and G0009 (pneumococcal vaccine administration) has 606 claims with $0 avg paid/claim; both codes rank #1 in-state and are labeled "extreme outlier, far above typical state volume." The combination of high claim counts and $0 average paid values is a notable operational pattern in the Medicaid dataset and should be reviewed when comparing reimbursement flows or program participation.
As a community/retail pharmacy (taxonomy), the code mix—dominated on Medicare by COVID test provisioning (K1034) and on Medicaid by vaccine and vaccine-administration related codes—points to a front-line retail immunization and testing role rather than specialty drug dispensing or procedural services. The presence of multiple vaccine CPT/HCPCS entries (90670, 90732, 90686 and several administration codes) supports an operational profile centered on walk-in immunizations and public-health-facing services.
The provider's competitive standing is mixed: nationally for the Medicare top code the provider appears high-ranked (#411 of 30143, 99th percentile) while most Medicaid vaccine codes are in mid-to-high in-state percentiles (examples: 90670 at the 40th percentile, 90686 at the 80th percentile), indicating it is an above-average but not uniformly dominant Medicaid participant across all vaccine products. This pattern suggests local strength in specific vaccine lines rather than broad dominance across all immunization services.
The NPI has been enumerated since 2005-12-02 (~21 years ago), indicating a long-established presence in the market; that tenure plus the concentrated service mix (testing and vaccinations) suggests a steady retail pharmacy operation that has maintained public-health service lines over time. Given Medicare revenue is fully dependent on a single code (K1034) and Medicaid revenue is driven in large part by the top three codes (63.7%), analysts should consider the potential business impact of coverage or reimbursement changes for those specific services when modeling future revenue trajectories.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 6,940 | $10 | $83.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 26 | 140 | 3,110 | $10 | $43.2K |
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 0002A | N/A | 1,770 | $30 | $46K |
| 90670 | This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and… | 220 | $190 | $41.8K |
| 0001A | N/A | 1,770 | $20 | $33.6K |
| 90732 | The provider intramuscularly or subcutaneously injects pneumococcal polysaccharide vaccine in an individual two years or older. This vaccine provides protection against meningitis and pneumonia that… | 250 | $100 | $24.7K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 950 | $20 | $16.1K |
| 0012A | N/A | 290 | $30 | $8.5K |
| 0003A | N/A | 190 | $40 | $7.5K |
| 0011A | N/A | 290 | $20 | $5.5K |
| 0013A | N/A | 50 | $40 | $1.9K |
| 0071A | N/A | 40 | $40 | $1.6K |
Showing 1–10 of 18
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
18 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 90472 | This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection. | 150 | 170 | 1,560 | $10 | $28K |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 168 | 210 | 1,600 | $10 | $27.7K |
| 0002A | N/A | 15 | 160 | 310 | $30 | $23.3K |
| 0001A | N/A | 19 | 160 | 370 | $30 | $20.7K |
| 0004A | N/A | 71 | 90 | 170 | $30 | $12K |
| 0012A | N/A | 59 | 140 | 240 | $30 | $11.9K |
| 0003A | N/A | 42 | 120 | 120 | $40 | $11.2K |
| 0011A | N/A | 63 | 140 | 240 | $20 | $9.9K |
| 0064A | N/A | 47 | 60 | 100 | $30 | $8.5K |
| 0013A | N/A | 43 | 60 | 100 | $30 | $7.5K |
Showing 1–10 of 18
Other providers in the same ZIP code as Empresas Bonilla Colon Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Laboratorio Sagrada Familia Corp. | PR | Clinical Medical Laboratory | $4.6K | $3M |
| Southern Hospital Services | PR | Emergency Medical Services (Emergency Medicine) Physician | $0 | $1.6M |
| Cdva Corp | PR | Health Maintenance Organization | $1.5K | $1.5M |
| Laboratorio Clinico Tierra Santa Inc | PR | Clinical Medical Laboratory | $2K | $1M |
| Southern Hospital Services | PR | Clinical Medical Laboratory | $0 | $976.5K |
| Southern Hospital Service Inc | PR | Multi-Specialty Clinic/Center | $0 | $753.1K |
| Laboratorio Clinico Alfeciza Inc. | PR | Clinical Medical Laboratory | $0 | $446K |
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