Supplier
Selah Mountain Pharmacy LLC
Selah Mountain Pharmacy LLC was paid $1.27M by Medicaid between May 2022 and Apr 2024, across 4 billing codes. Its largest line is E1399, Durable medical equipment, miscellaneous — 99% of everything it billed.
33Billing provider infoSELAH MOUNTAIN PHARMACY LLC
PAGOSA SPRINGS, CO 81147
PAGOSA SPRINGS, CO 81147
33aNPI1497211379assigned 02/15/2019
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$1.27M
24GClaims9,733
24DCodes billed4
24AFirst – last monthMay 2022 – Apr 2024
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Colorado
Rank by total paid#66 of 645
Median peer was paid$21K
This provider vs. median62×
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 | |
|---|---|---|---|
| 2022 | 124 | $4K | |
| 2023 | 155 | $4K | |
| 2024incomplete | 9,454 | $1.27M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| E1399 | Durable medical equipment, miscellaneous | 99% | 9,348 | 8,580 | $1.26M |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 1.1% | 233 | 227 | $14K |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | <1% | 124 | 113 | $4K |
| T5999 | Supply, not otherwise specified | 0% | 28 | 27 | $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 officialKUTZKO, JOHN (MANAGING MEMBER)