BROAD AVENUE PHARMACY LLC
NPI: 1669948162
· NEW ORLEANS, LA 70119
· Pharmacy
· NPI assigned 10/23/2018
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | QUACH, PHAT (PHARMACY MANAGER) |
| NPI Enumeration Date | 10/23/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
821 |
$0.00 |
| 2022 |
43 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0011A |
|
510 |
495 |
$0.00 |
| 0012A |
|
110 |
110 |
$0.00 |
| 0064A |
|
171 |
170 |
$0.00 |
| 0001A |
|
29 |
29 |
$0.00 |
| 0004A |
|
44 |
44 |
$0.00 |