Supplier
Pennsylvania CVS Pharmacy, L.L.C.
Pennsylvania CVS Pharmacy, L.L.C. was paid $344K by Medicaid between Aug 2022 and Dec 2024, across 18 billing codes. Its largest line is 90750, — 22% of everything it billed.
33Billing provider infoPENNSYLVANIA CVS PHARMACY, L.L.C.
HAWLEY, PA 18428
HAWLEY, PA 18428
33aNPI1376641993assigned 09/20/2006
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$344K
24GClaims16,791
24DCodes billed18
24AFirst – last monthAug 2022 – Dec 2024
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Pennsylvania
Rank by total paid#118 of 279
Median peer was paid$181K
This provider vs. median1.9×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official COLBERT, SUSAN controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2022 | 648 | $0.00 | |
| 2023 | 6,157 | $3K | |
| 2024incomplete | 9,986 | $341K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90750 | 22% | 605 | 598 | $75K | |
| 90661 | 17% | 1,869 | 1,863 | $57K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 14% | 7,471 | 7,367 | $49K |
| 90739 | 13% | 276 | 274 | $46K | |
| 90656 | 8.5% | 1,482 | 1,481 | $29K | |
| 90677 | 7.7% | 130 | 130 | $27K | |
| 91320 | 6.4% | 251 | 251 | $22K | |
| 90715 | 3.5% | 318 | 317 | $12K | |
| 91322 | 3.5% | 127 | 127 | $12K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.4% | 590 | 569 | $5K |
| 90679 | 1.2% | 126 | 125 | $4K | |
| 90662 | 1.0% | 202 | 201 | $4K |
6 more codes
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 officialCOLBERT, SUSAN (DIR PHCY ENROLLMENTS)
| Provider | Location | Paid |
|---|---|---|
| Montana CVS Pharmacy LLC | Anaconda, MT | $15K |
| Wisconsin CVS Pharmacy LLC | Appleton, WI | $13K |
| Wisconsin CVS Pharmacy LLC | Green Bay, WI | $10K |
| Wisconsin CVS Pharmacy LLC | Milwaukee, WI | $5K |
| American Drug Stores Delaware LLC | Fargo, ND | $3K |
| Wisconsin CVS Pharmacy LLC | Wauwatosa, WI | $3K |
| Wisconsin CVS Pharmacy LLC | Kenosha, WI | $3K |
| Wisconsin CVS Pharmacy LLC | Cudahy, WI | $2K |
| Wisconsin CVS Pharmacy LLC | Janesville, WI | $938.31 |
| CVS Pharmacy, INC. | Big Spring, TX | $900.03 |
| Garfield Beach CVS, L.L.C. | Redding, CA | $493.69 |
| Hook-Superx LLC | Terre Haute, IN | $424.35 |
| Wisconsin CVS Pharmacy LLC | Green Bay, WI | $310.51 |
| Garfield Beach CVS LLC | Mission Hills, CA | $301.55 |
| Garfield Beach CVS LLC | Sand City, CA | $210.35 |
| Garfield Beach CVS LLC | Los Angeles, CA | $173.03 |
| Garfield Beach CVS LLC | Gardena, CA | $173.03 |
| Arizona CVS Stores LLC | Tucson, AZ | $118.58 |
| Garfield Beach CVS LLC | Burbank, CA | $0.00 |
| Garfield Beach CVS LLC | San Jose, CA | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.