Supplier
Fairfax Discount Pharmacy INC
Fairfax Discount Pharmacy INC was paid $90K by Medicaid between Jan 2018 and Dec 2022, across 8 billing codes. Its largest line is T4523, Adult sized disposable incontinence product, brief/diaper, large, each — 35% of everything it billed.
33Billing provider infoFAIRFAX DISCOUNT PHARMACY INC
LOS ANGELES, CA 90036
LOS ANGELES, CA 90036
33aNPI1104995059assigned 11/07/2006
33bProvider typePharmacy
28Total paid$90K
24GClaims4,784
24DCodes billed8
24AFirst – last monthJan 2018 – Dec 2022
Compared with peers
Next to other Pharmacy providers in California
Rank by total paid#32 of 179
Median peer was paid$2K
This provider vs. median51×
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 | 3,720 | $85K | |
| 2019 | 573 | $4K | |
| 2020 | 149 | $395.51 | |
| 2021 | 195 | $742.93 | |
| 2022 | 147 | $541.31 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T4523 | Adult sized disposable incontinence product, brief/diaper, large, each | 35% | 549 | 526 | $31K |
| T4541 | Incontinence product, disposable underpad, large, each | 31% | 606 | 585 | $28K |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | 17% | 607 | 585 | $15K |
| T4536 | Incontinence product, protective underwear/pull-on, reusable, any size, each | 7.6% | 559 | 540 | $7K |
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 5.7% | 951 | 795 | $5K |
| A6250 | Skin sealants, protectants, moisturizers, ointments, any type, any size | 3.0% | 323 | 316 | $3K |
| A4335 | Incontinence supply; miscellaneous | <1% | 321 | 310 | $701.50 |
| A4259 | Lancets, per box of 100 | <1% | 868 | 730 | $331.61 |
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 officialGOROKHOVSKY, BORIS (MGR)