Supplier
Mantachie Pharmacy LLC
Mantachie Pharmacy LLC was paid $4.10M by Medicaid between Jun 2020 and Dec 2024, across 11 billing codes. Its largest line is A9276, Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply — 35% of everything it billed.
33Billing provider infoMANTACHIE PHARMACY LLC
MANTACHIE, MS 38855
MANTACHIE, MS 38855
33aNPI1992292536assigned 04/19/2018
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$4.10M
24GClaims11,514
24DCodes billed11
24AFirst – last monthJun 2020 – Dec 2024
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Mississippi
Rank by total paid#11 of 173
Median peer was paid$16K
This provider vs. median259×
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 | |
|---|---|---|---|
| 2020 | 141 | $3K | |
| 2021 | 897 | $61K | |
| 2022 | 1,771 | $152K | |
| 2023 | 4,368 | $1.93M | |
| 2024incomplete | 4,337 | $1.95M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | 35% | 3,357 | 2,874 | $1.45M |
| E0784 | External ambulatory infusion pump, insulin | 21% | 241 | 200 | $846K |
| A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | 16% | 1,401 | 1,038 | $641K |
| A9277 | Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | 15% | 1,270 | 1,096 | $632K |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 5.2% | 2,691 | 2,125 | $214K |
| A9278 | Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | 4.1% | 386 | 329 | $169K |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 2.0% | 1,622 | 1,441 | $83K |
| A4238 | Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 1.4% | 428 | 318 | $59K |
| A5500 | For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe | <1% | 51 | 25 | $1K |
| K0554 | Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system | <1% | 16 | 13 | $1K |
| A5512 | For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each | 0% | 51 | 25 | $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 officialSPRADLING, KATLYN (PHARMACIST)