NPI: 1740490341 · WEST SACRAMENTO, CA 95605 · Durable Medical Equipment & Medical Supplies · NPI assigned 05/23/2007
| Authorized Official | CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT) |
| NPI Enumeration Date | 05/23/2007 |
Other providers sharing the same authorized official: CANONIC, KIMBERLY
| Provider | City | State | Total Paid |
|---|---|---|---|
| WALMART INC. | INDEPENDENCE | IA | $7K |
| WALMART INC. | ANKENY | IA | $3K |
| WALMART INC. | WINDSOR HEIGHTS | IA | $2K |
| WALMART INC. | IOWA CITY | IA | $2K |
| WALMART INC. | CENTERVILLE | IA | $2K |
| WALMART INC. | DENISON | IA | $2K |
| WALMART INC. | WEST BURLINGTON | IA | $1K |
| WALMART INC. | MONTICELLO | AR | $1K |
| WALMART INC. | MASON CITY | IA | $919.50 |
| WAL-MART STORES EAST LP | KENDALL | FL | $301.97 |
| WALMART INC. | WASECA | MN | $242.86 |
| WAL-MART STORES EAST LP | HIALEAH | FL | $160.00 |
| WALMART INC. | BROOKLYN PARK | MN | $81.46 |
| WAL-MART STORES EAST LP | EVANSVILLE | IN | $74.87 |
| WALMART INC. | PINE CITY | MN | $63.44 |
| WALMART INC. | ANAMOSA | IA | $41.46 |
| WAL-MART STORES EAST LP | JACKSONVILLE | FL | $28.39 |
| WALMART INC. | SHENANDOAH | IA | $22.95 |
| WAL-MART STORES EAST LP | OCALA | FL | $1.12 |
| WALMART INC. | FAYETTEVILLE | AR | $0.07 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 72 | $277.87 |
| 2021 | 96 | $614.58 |
| 2022 | 16 | $54.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A9999 | Miscellaneous dme supply or accessory, not otherwise specified | 184 | 165 | $946.45 |