FOURTH AVE PHARMACY LLC
NPI: 1225130354
· NEWARK, NJ 07107
· Specialty Pharmacy
· NPI assigned 09/01/2006
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | GAJERA, AYUSH (PHARMACIST) |
| NPI Enumeration Date | 09/01/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
32 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
32 |
31 |
$0.00 |