Supplier
Clearwater Canyon Pharmacy, LLC
Clearwater Canyon Pharmacy, LLC was paid $187.25 by Medicaid between Jan 2023 and Jan 2023, 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 infoCLEARWATER CANYON PHARMACY, LLC
OROFINO, ID 83544
OROFINO, ID 83544
33aNPI1598229809assigned 01/31/2019
33bProvider typeCommunity/Retail Pharmacy
28Total paid$187.25
24GClaims12
24DCodes billed1
24AFirst – last monthJan 2023 – Jan 2023
Compared with peers
Next to other Community/Retail Pharmacy providers in Idaho
Rank by total paid#10 of 11
Median peer was paid$940.16
This provider vs. median0.2×
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 | |
|---|---|---|---|
| 2023 | 12 | $187.25 |
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% | 12 | 12 | $187.25 |
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 officialPOTTENGER, CHARLES (OWNER/PRESIDENT)