NORTHSIDE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

NPI: 1114904133 · WINSTON-SALEM, NC 27105 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI assigned 12/30/2005

$5K

Total Medicaid Paid

630

Total Claims

Beneficiaries

Codes Billed

2022-01

First Month

2022-04

Last Month

Provider Details

Authorized Official	HALES, TERRY (ASSISTANT TREASURER)
NPI Enumeration Date	12/30/2005

Other providers sharing the same authorized official: HALES, TERRY

Provider	City	State	Total Paid
PIEDMONT DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	WINSTON-SALEM	NC	$1.28M
HIGH POINT KIDNEY CENTER OF WAKE FOREST UNIVERSITY	HIGH POINT	NC	$1.19M
SALEM KIDNEY CENTER OF WAKE FOREST UNIVERSITY	WINSTON-SALEM	NC	$920K
LEXINGTON DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	LEXINGTON	NC	$714K
MILLER STREET DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	WINSTON SALEM	NC	$563K
WEST IREDELL DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	STATESVILLE	NC	$245K
WILKES DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	NORTH WILKESBORO	NC	$126K
LAKE NORMAN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	MOORESVILLE	NC	$70K
STATESVILLE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	STATESVILLE	NC	$56K
TRIAD DIALYSIS CENTER OF WAKE FOREST UNIVERSITY	HIGH POINT	NC	$3K

Year	Claims	Total Paid
2022	630	$5K

Code	Description	Claims	Beneficiaries	Total Paid
90937		492	48	$4K
J0882	Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)	91	24	$1K
J1756	Injection, iron sucrose, 1 mg	47	12	$239.74