Supplier
Pure Vita Co.
Pure Vita Co. was paid $347K by Medicaid between Nov 2019 and Jan 2022, across 13 billing codes. Its largest line is T4527, Adult sized disposable incontinence product, protective underwear/pull-on, large size, each — 32% of everything it billed.
33Billing provider infoPURE VITA CO.
BOISE, ID 83704
BOISE, ID 83704
33aNPI1558840900assigned 08/07/2018
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$347K
24GClaims5,298
24DCodes billed13
24AFirst – last monthNov 2019 – Jan 2022
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Idaho
Rank by total paid#16 of 111
Median peer was paid$10K
This provider vs. median36×
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 | |
|---|---|---|---|
| 2019 | 182 | $14K | |
| 2020 | 1,980 | $146K | |
| 2021 | 3,072 | $182K | |
| 2022 | 64 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | 32% | 1,046 | 987 | $113K |
| T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | 25% | 857 | 801 | $86K |
| T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | 19% | 533 | 492 | $66K |
| 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 | 11% | 590 | 520 | $38K |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | 3.8% | 394 | 355 | $13K |
| T4537 | Incontinence product, protective underpad, reusable, bed size, each | 3.8% | 1,215 | 1,123 | $13K |
| A4772 | Blood glucose test strips, for dialysis, per 50 | 1.6% | 167 | 80 | $6K |
| T4543 | Adult sized disposable incontinence product, protective brief/diaper, above extra large, each | 1.2% | 29 | 27 | $4K |
| T4541 | Incontinence product, disposable underpad, large, each | <1% | 166 | 155 | $3K |
| T4530 | Pediatric sized disposable incontinence product, brief/diaper, large size, each | <1% | 39 | 37 | $2K |
| T4522 | Adult sized disposable incontinence product, brief/diaper, medium, each | <1% | 12 | 12 | $2K |
| A4258 | Spring-powered device for lancet, each | <1% | 202 | 103 | $786.84 |
1 more codes
| A4245 | Alcohol wipes, per box | <1% | 48 | $232.65 |
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 officialLAWHORN, DARCY (OWNER)