Supplier
Fourth Ave Pharmacy LLC
Fourth Ave Pharmacy LLC was paid $0.00 by Medicaid between Aug 2022 and Oct 2022, across 1 billing code. Its largest line is K1034, Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count — 0% of everything it billed.
33Billing provider infoFOURTH AVE PHARMACY LLC
NEWARK, NJ 07107
NEWARK, NJ 07107
33aNPI1225130354assigned 09/01/2006
33bProvider typeSpecialty Pharmacy
28Total paid$0.00
24GClaims32
24DCodes billed1
24AFirst – last monthAug 2022 – Oct 2022
Compared with peers
Next to other Specialty Pharmacy providers in New Jersey
Rank by total paid#3 of 5
Median peer was paid$0.00
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2022 | 32 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 0% | 32 | 31 | $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 officialGAJERA, AYUSH (PHARMACIST)