Supplier
Legacy Medical Supply LLC
Legacy Medical Supply LLC was paid $151K by Medicaid between Dec 2018 and Oct 2020, across 11 billing codes. Its largest line is B4100, Food thickener, administered orally, per ounce — 31% of everything it billed.
33Billing provider infoLEGACY MEDICAL SUPPLY LLC
PEARL CITY, HI 96782
PEARL CITY, HI 96782
33aNPI1538680160assigned 07/05/2017
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$151K
24GClaims3,098
24DCodes billed11
24AFirst – last monthDec 2018 – Oct 2020
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Hawaii
Rank by total paid#21 of 123
Median peer was paid$20K
This provider vs. median7.5×
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.
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 | 12 | $1K | |
| 2019 | 1,516 | $76K | |
| 2020 | 1,570 | $74K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| B4100 | Food thickener, administered orally, per ounce | 31% | 282 | 273 | $46K |
| 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 | 17% | 376 | 362 | $26K |
| T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | 11% | 258 | 242 | $17K |
| T4523 | Adult sized disposable incontinence product, brief/diaper, large, each | 11% | 197 | 187 | $17K |
| T4541 | Incontinence product, disposable underpad, large, each | 8.2% | 862 | 812 | $12K |
| E0260 | Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress | 6.4% | 125 | 123 | $10K |
| T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | 5.2% | 90 | 88 | $8K |
| A4927 | Gloves, non-sterile, per 100 | 5.0% | 820 | 771 | $8K |
| T4522 | Adult sized disposable incontinence product, brief/diaper, medium, each | 3.3% | 50 | 50 | $5K |
| B4154 | Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 1.5% | 12 | 12 | $2K |
| K0001 | Standard wheelchair | <1% | 26 | 26 | $1K |
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 officialRAMENTO, JOVELYN MARIE (OWNER / GENERAL MANAGER)