NPI: 1497772628 · GIBSONIA, PA 15044 · Durable Medical Equipment & Medical Supplies · NPI assigned 07/16/2006
| Authorized Official | LITTLE, SARAH (DIRECTOR OF HEALTHCARE CONTRACTING) |
| NPI Enumeration Date | 07/16/2006 |
Other providers sharing the same authorized official: LITTLE, SARAH
| Provider | City | State | Total Paid |
|---|---|---|---|
| WAL-MART STORES EAST LP | TAMPA | FL | $6K |
| WALMART INC. | OTTUMWA | IA | $3K |
| WALMART INC. | BOONE | IA | $2K |
| WALMART INC. | CRESTON | IA | $2K |
| WALMART INC. | INDIANOLA | IA | $2K |
| WALMART INC. | KEOKUK | IA | $767.57 |
| WALMART INC. | FOREST LAKE | MN | $692.41 |
| WALMART INC. | WATERLOO | IA | $590.29 |
| WALMART INC. | MANCHESTER | IA | $440.00 |
| WALMART INC. | MAQUOKETA | IA | $404.34 |
| WAL-MART STORES EAST LP | MIRAMAR | FL | $216.94 |
| WAL-MART STORES EAST LP | LEESBURG | FL | $200.00 |
| WAL-MART STORES EAST LP | HAMMOND | IN | $189.72 |
| WALMART INC. | OWATONNA | MN | $162.92 |
| WAL-MART STORES EAST LP | CORAL SPRINGS | FL | $160.00 |
| WALMART INC. | STORM LAKE | IA | $156.11 |
| WAL-MART STORES EAST LP | TALLAHASSEE | FL | $155.52 |
| WAL-MART STORES EAST LP | SEBRING | FL | $120.00 |
| WAL-MART STORES EAST LP | GREENACRES | FL | $120.00 |
| WAL-MART STORES EAST LP | JACKSONVILLE | FL | $96.94 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $956.00 |
| 2019 | 16 | $300.00 |
| 2020 | 452 | $13K |
| 2021 | 1,392 | $57K |
| 2022 | 2,030 | $94K |
| 2023 | 1,786 | $70K |
| 2024 | 966 | $36K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2025 | Deluxe frame | 3,255 | 2,845 | $203K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 1,788 | 1,598 | $30K |
| V2520 | Contact lens, hydrophilic, spherical, per lens | 169 | 143 | $11K |
| V2750 | Anti-reflective coating, per lens | 548 | 495 | $7K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 413 | 381 | $6K |
| V2781 | Progressive lens, per lens | 40 | 27 | $4K |
| V2020 | Frames, purchases | 157 | 143 | $4K |
| V2523 | Contact lens, hydrophilic, extended wear, per lens | 55 | 44 | $4K |
| V2744 | Tint, photochromatic, per lens | 40 | 40 | $2K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 165 | 160 | $2K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 12 | 12 | $345.50 |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 12 | 12 | $152.00 |