Supplier
Red River Pharmacy Services INC
Red River Pharmacy Services INC was paid $35K by Medicaid between Jan 2018 and Apr 2023, across 8 billing codes. Its largest line is A4305, Disposable drug delivery system, flow rate of 50 ml or greater per hour — 45% of everything it billed.
33Billing provider infoRED RIVER PHARMACY SERVICES INC
TEXARKANA, TX 75503
TEXARKANA, TX 75503
33aNPI1356455638assigned 08/17/2006
33bProvider typeCommunity/Retail Pharmacy
28Total paid$35K
24GClaims1,644
24DCodes billed8
24AFirst – last monthJan 2018 – Apr 2023
Compared with peers
Next to other Community/Retail Pharmacy providers in Texas
Rank by total paid#8 of 52
Median peer was paid$643.64
This provider vs. median55×
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 | |
|---|---|---|---|
| 2018 | 1,120 | $14K | |
| 2019 | 49 | $507.20 | |
| 2020 | 242 | $17K | |
| 2021 | 23 | $160.05 | |
| 2022 | 127 | $2K | |
| 2023 | 83 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A4305 | Disposable drug delivery system, flow rate of 50 ml or greater per hour | 45% | 96 | 32 | $16K |
| A4209 | Syringe with needle, sterile 5 cc or greater, each | 32% | 509 | 179 | $11K |
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | 12% | 248 | 78 | $4K |
| B4152 | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 6.4% | 20 | 12 | $2K |
| A6209 | Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | 2.8% | 149 | 51 | $973.38 |
| A4927 | Gloves, non-sterile, per 100 | 1.1% | 184 | 82 | $392.19 |
| A6257 | Transparent film, sterile, 16 sq. in. or less, each dressing | <1% | 218 | 78 | $239.85 |
| A6216 | Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 220 | 78 | $118.56 |
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 officialBOUDREAUX, DAVID (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Red River Pharmacy of Jonesboro LLC | Jonesboro, AR | $33K |
| Red River Pharmacy Long Term Care, LLC | Texarkana, TX | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.