Medicaid Provider Spending

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

MANTACHIE PHARMACY LLC

NPI: 1992292536 · MANTACHIE, MS 38855 · Durable Medical Equipment & Medical Supplies · NPI assigned 04/19/2018

$4.10M
Total Medicaid Paid
11,514
Total Claims
9,484
Beneficiaries
11
Codes Billed
2020-06
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSPRADLING, KATLYN (PHARMACIST)
NPI Enumeration Date04/19/2018

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 141 $3K
2021 897 $61K
2022 1,771 $152K
2023 4,368 $1.93M
2024 4,337 $1.95M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal 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 3,357 2,874 $1.45M
E0784 External ambulatory infusion pump, insulin 241 200 $846K
A9274 External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories 1,401 1,038 $641K
A9277 Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system 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 2,691 2,125 $214K
A9278 Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system 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 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 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 51 25 $1K
K0554 Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system 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 51 25 $0.00