Supplier
Hallettsville Pharmacy LLC
Hallettsville Pharmacy LLC was paid $25K by Medicaid between Nov 2019 and Nov 2024, across 4 billing codes. Its largest line is A4554, Disposable underpads, all sizes — 83% of everything it billed.
33Billing provider infoHALLETTSVILLE PHARMACY LLC
HALLETTSVILLE, TX 77964
HALLETTSVILLE, TX 77964
33aNPI1043382849assigned 11/15/2006
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$25K
24GClaims1,356
24DCodes billed4
24AFirst – last monthNov 2019 – Nov 2024
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Texas
Rank by total paid#394 of 566
Median peer was paid$142K
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 | |
|---|---|---|---|
| 2019 | 75 | $2K | |
| 2020 | 402 | $9K | |
| 2021 | 359 | $7K | |
| 2022 | 175 | $2K | |
| 2023 | 211 | $4K | |
| 2024incomplete | 134 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A4554 | Disposable underpads, all sizes | 83% | 556 | 556 | $21K |
| A4335 | Incontinence supply; miscellaneous | 17% | 769 | 769 | $4K |
| 0003A | 0% | 18 | 18 | $0.00 | |
| 0004A | 0% | 13 | 13 | $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 officialGRAHMANN, PAULA (PRESIDENT / OWNER)