Supplier
Rocky Mountain Pharmacy, LLC
Rocky Mountain Pharmacy, LLC was paid $342K by Medicaid between Apr 2022 and Dec 2024, across 8 billing codes. Its largest line is A4239, Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service — 87% of everything it billed.
33Billing provider infoROCKY MOUNTAIN PHARMACY, LLC
IDAHO FALLS, ID 83404
IDAHO FALLS, ID 83404
33aNPI1851923544assigned 02/10/2020
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$342K
24GClaims2,368
24DCodes billed8
24AFirst – last monthApr 2022 – Dec 2024
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Idaho
Rank by total paid#17 of 111
Median peer was paid$10K
This provider vs. median35×
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 | 101 | $20K | |
| 2023 | 1,533 | $199K | |
| 2024incomplete | 734 | $123K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 87% | 1,571 | 1,370 | $296K |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 5.8% | 101 | 86 | $20K |
| A4224 | Supplies for maintenance of insulin infusion catheter, per week | 4.2% | 300 | 280 | $14K |
| A4225 | Supplies for external insulin infusion pump, syringe type cartridge, sterile, each | 2.4% | 325 | 311 | $8K |
| A9277 | Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | <1% | 17 | 16 | $2K |
| A4215 | Needle, sterile, any size, each | <1% | 13 | 13 | $375.00 |
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | <1% | 27 | 25 | $360.88 |
| A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | 0% | 14 | 14 | $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 officialCOULSON, TROY (PHARMACIST IN CHARGE)