Davila Pharmacy, INC.

Davila Pharmacy, INC. was paid $13.44M by Medicaid between Jan 2018 and Dec 2024, across 51 billing codes. Its largest line is A4554, Disposable underpads, all sizes — 12% of everything it billed.

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	11,993	$571K
2019	13,087	$636K
2020	24,147	$1.31M
2021	52,979	$3.33M
2022	49,607	$2.93M
2023	46,886	$2.67M
2024incomplete	34,750	$1.99M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
A4554	Disposable underpads, all sizes	12%	50,891	48,650	$1.68M
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	11%	11,109	10,776	$1.53M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	9.1%	10,974	10,337	$1.23M
T4526	Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each	8.1%	9,732	9,282	$1.08M
T4528	Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each	6.9%	5,644	5,444	$922K
B4153	Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	6.0%	408	398	$800K
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	4.9%	2,273	2,189	$655K
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	4.3%	15,980	15,331	$574K
B4152	Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	3.9%	1,555	1,428	$529K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	3.4%	1,616	1,544	$450K
T4522	Adult sized disposable incontinence product, brief/diaper, medium, each	3.3%	4,659	4,445	$437K
T4523	Adult sized disposable incontinence product, brief/diaper, large, each	3.0%	4,093	3,944	$403K

39 more codes

B9998	Noc for enteral supplies	2.7%	4,132	$359K
B4150	Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	2.6%	1,289	$347K
A4335	Incontinence supply; miscellaneous	2.4%	62,262	$319K
T4532	Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each	2.0%	1,781	$270K
T4524	Adult sized disposable incontinence product, brief/diaper, extra large, each	1.9%	2,154	$260K
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	1.8%	1,383	$248K
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	1.8%	9,710	$248K
T4544	Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each	1.6%	1,123	$221K
T4525	Adult sized disposable incontinence product, protective underwear/pull-on, small size, each	1.1%	1,719	$150K
T4530	Pediatric sized disposable incontinence product, brief/diaper, large size, each	<1%	1,382	$113K
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	<1%	1,314	$86K
E0570	Nebulizer, with compressor	<1%	1,228	$73K
A4414	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each	<1%	400	$60K
B4155	Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit	<1%	184	$56K
A4259	Lancets, per box of 100	<1%	7,318	$50K
T4521	Adult sized disposable incontinence product, brief/diaper, small, each	<1%	448	$46K
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit	<1%	48	$43K
A4670	Automatic blood pressure monitor	<1%	756	$39K
A7000	Canister, disposable, used with suction pump, each	<1%	755	$38K
A5063	Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each	<1%	462	$32K
A7002	Tubing, used with suction pump, each	<1%	761	$12K
A6250	Skin sealants, protectants, moisturizers, ointments, any type, any size	<1%	1,353	$12K
A4322	Irrigation syringe, bulb or piston, each	<1%	1,051	$9K
A7003	Administration set, with small volume nonfiltered pneumatic nebulizer, disposable	<1%	2,506	$8K
B4100	Food thickener, administered orally, per ounce	<1%	139	$6K
A6216	Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	<1%	1,408	$6K
A4406	Ostomy skin barrier, pectin-based, paste, per ounce	<1%	465	$6K
A4402	Lubricant, per ounce	<1%	941	$4K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	<1%	1,653	$4K
A4245	Alcohol wipes, per box	<1%	2,408	$4K
A4628	Oral and/or oropharyngeal suction catheter, each	<1%	664	$4K
A5120	Skin barrier, wipes or swabs, each	<1%	503	$4K
A4456	Adhesive remover, wipes, any type, each	<1%	420	$3K
A4371	Ostomy skin barrier, powder, per oz	<1%	119	$1K
E0240	Bath/shower chair, with or without wheels, any size	<1%	24	$894.48
A4358	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each	<1%	76	$733.58
A4450	Tape, non-waterproof, per 18 square inches	<1%	97	$433.22
A4357	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	<1%	41	$210.27
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	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 officialDAVILA, RUDY (VICE PRESIDENT OWNER)