Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PALMYRA PHARMACY LLC

NPI: 1689922569 · PALMYRA, NJ 08065 · Pharmacy · NPI assigned 08/27/2012

$160.00
Total Medicaid Paid
907
Total Claims
895
Beneficiaries
12
Codes Billed
2021-04
First Month
2024-09
Last Month

Provider Details

Authorized OfficialNATHANI, JITENKUMAR (PRESIDENT)
NPI Enumeration Date08/27/2012

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 247 $160.00
2022 279 $0.00
2023 238 $0.00
2024 143 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0031A 20 14 $80.00
0003A 46 45 $80.00
90694 188 188 $0.00
K1034 Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count 54 54 $0.00
90480 45 45 $0.00
0064A 22 22 $0.00
G0008 Administration of influenza virus vaccine 261 260 $0.00
90653 71 70 $0.00
0054A 43 43 $0.00
91322 45 45 $0.00
0124A 65 65 $0.00
0013A 47 44 $0.00