Agency
Red River Pharmacy of Jonesboro LLC
Red River Pharmacy of Jonesboro LLC was paid $33K by Medicaid between Nov 2018 and Feb 2024, across 7 billing codes. Its largest line is A4221, Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) — 51% of everything it billed.
33Billing provider infoRED RIVER PHARMACY OF JONESBORO LLC
JONESBORO, AR 72401
JONESBORO, AR 72401
33aNPI1609323922assigned 09/02/2016
33bProvider typeHome Infusion Agency
28Total paid$33K
24GClaims1,847
24DCodes billed7
24AFirst – last monthNov 2018 – Feb 2024
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 | 56 | $655.98 | |
| 2019 | 822 | $18K | |
| 2020 | 44 | $565.50 | |
| 2021 | 189 | $2K | |
| 2022 | 379 | $4K | |
| 2023 | 289 | $6K | |
| 2024incomplete | 68 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | 51% | 1,198 | 423 | $17K |
| A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | 34% | 153 | 28 | $11K |
| E0779 | Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater | 8.1% | 353 | 26 | $3K |
| 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 | 5.5% | 22 | 12 | $2K |
| A6209 | Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 41 | 13 | $177.25 |
| A6257 | Transparent film, sterile, 16 sq. in. or less, each dressing | <1% | 40 | 13 | $23.40 |
| A6216 | Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | <1% | 40 | 13 | $11.40 |
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 (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Red River Pharmacy Services INC | Texarkana, TX | $35K |
| 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.