Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

ROCKY MOUNTAIN PHARMACY, LLC

NPI: 1851923544 · IDAHO FALLS, ID 83404 · Durable Medical Equipment & Medical Supplies · NPI assigned 02/10/2020

$342K
Total Medicaid Paid
2,368
Total Claims
2,115
Beneficiaries
8
Codes Billed
2022-04
First Month
2024-12
Last Month

Provider Details

Authorized OfficialCOULSON, TROY (PHARMACIST IN CHARGE)
NPI Enumeration Date02/10/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 101 $20K
2023 1,533 $199K
2024 734 $123K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal 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 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 101 86 $20K
A4224 Supplies for maintenance of insulin infusion catheter, per week 300 280 $14K
A4225 Supplies for external insulin infusion pump, syringe type cartridge, sterile, each 325 311 $8K
A9277 Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system 17 16 $2K
A4215 Needle, sterile, any size, each 13 13 $375.00
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 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 14 14 $0.00