Supplier
Mountain Lake Pharmacy INC
Mountain Lake Pharmacy INC was paid $708.88 by Medicaid between Jan 2020 and Feb 2022, across 1 billing code. Its largest line is A4253, Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips — 100% of everything it billed.
33Billing provider infoMOUNTAIN LAKE PHARMACY INC
SUMMERSVILLE, WV 26651
SUMMERSVILLE, WV 26651
33aNPI1336228006assigned 11/03/2006
33bProvider typePharmacy
28Total paid$708.88
24GClaims88
24DCodes billed1
24AFirst – last monthJan 2020 – Feb 2022
Compared with peers
Next to other Pharmacy providers in West Virginia
Rank by total paid#19 of 38
Median peer was paid$659.92
This provider vs. median1.1×
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 | |
|---|---|---|---|
| 2020 | 30 | $227.97 | |
| 2021 | 40 | $356.10 | |
| 2022 | 18 | $124.81 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 100% | 88 | 79 | $708.88 |
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 officialBOONE, HOWARD (PRESIDENT PIC)