Supplier
Mountain Street Pharmacy INC
Mountain Street Pharmacy INC was paid $650.00 by Medicaid between Nov 2021 and Oct 2022, across 4 billing codes. Its largest line is 0013A, — 100% of everything it billed.
33Billing provider infoMOUNTAIN STREET PHARMACY INC
KINGS MOUNTAIN, NC 28086
KINGS MOUNTAIN, NC 28086
33aNPI1447316716assigned 12/29/2006
33bProvider typePharmacy
28Total paid$650.00
24GClaims62
24DCodes billed4
24AFirst – last monthNov 2021 – Oct 2022
Compared with peers
Next to other Pharmacy providers in North Carolina
Rank by total paid#59 of 97
Median peer was paid$1K
This provider vs. median0.6×
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 | |
|---|---|---|---|
| 2021 | 32 | $650.00 | |
| 2022 | 30 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 0013A | 100% | 16 | 14 | $650.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 14 | 14 | $0.00 |
| 901301 | 0% | 16 | 14 | $0.00 | |
| 90686 | 0% | 16 | 15 | $0.00 |
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 officialPROPST, ALLAN (PRESIDENT)