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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMedical Pharmacy And Lab
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    Medical Pharmacy And Lab — Billing Profile & Reimbursement Data

    NPI 1578772356 · San Juan, PR · Exclusive Provider Organization

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    Medical Pharmacy And Lab is a exclusive provider organization provider located in San Juan, Puerto Rico. This profile covers 0 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMedical Pharmacy And Lab
    AddressAvenida Andglucia 771 Puerto Nuevo
    CitySan Juan
    StatePR
    ZIP00921
    TaxonomyExclusive Provider Organization
    NPI EnumeratedMay 21, 2007
    NPI DeactivatedJuly 17, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$2.5M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    96160The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…92,000$10$1.3M
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…463,040$1$463K
    A0130Non-emergency transportation: wheelchair van8,190$30$254K
    99050In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.59,630$1$178.9K
    A0110Non-emergency transportation and bus, intra or inter state carrier5,670$20$107.8K
    99441N/A99,430$1$99.4K
    S0215Non-emergency transportation; mileage, per mile13,250$10$66.2K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…15,400$1$30.8K
    93000The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…3,690$1$3.7K
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…200$1$200

    Showing 1–10 of 17

    Medicaid: Competitive Analysis & Benchmarks

    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

    17 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    A0110Non-emergency transportation and bus, intra or inter state carrier9204,700$30$1.5M
    A0130Non-emergency transportation: wheelchair van4109,280$40$747K
    S0215Non-emergency transportation; mileage, per mile2107,780$10$63.2K
    99050In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.1901,090$10$47K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…145280210$30$43.8K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…8316090$90$31.8K
    93000The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…37410390$20$21.7K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…1840340$1$16.7K
    96160The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…147070$10$15.2K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…1320130$20$12.7K

    Showing 1–10 of 17

    Nearby Providers

    Other providers in the same ZIP code as Medical Pharmacy And Lab, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jose Garcia GonzalezPRRetina Specialist (Ophthalmology) Physician$1.9M$3.4M
    Recinto De Ciencias MedicasPRObstetrics & Gynecology Physician$0$3.8M
    Metrohealth Radiation Oncology Group, Inc.PRSpecialist$0$2.5M
    Metropolitan Mri Associates PscPRNeuroradiology Physician$0$2.1M
    Pediatrics Management ServicesPRMedical Specialty Clinic/Center$0$1.8M
    Luis RodriguezPRDiagnostic Radiology Physician$2K$1.3M
    Metrohealth, Inc.PRGeneral Acute Care Hospital$0$905.1K
    Minerva NunezPRGeneral Practice Dentistry$0$761.4K
    Elizabeth Calderon-aliceaPRHematology & Oncology Physician$0$707.2K
    Las Lomas Laboratory Inc.PRClinical Medical Laboratory$29.6K$630.1K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    5 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Medical Pharmacy And Lab — 5 of 13 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico