CVS-SHC KIDNEY CARE HOME DIALYSIS OF LOS ANGELES LLC
NPI: 1134740848
· SOUTH GATE, CA 90280
· 261QE0700X
$2.34M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
4,545 |
$255K |
| 2022 |
14,587 |
$1.42M |
| 2023 |
6,125 |
$656K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90999 |
|
18,369 |
1,200 |
$1.47M |
| 0821 |
|
4,245 |
357 |
$591K |
| Q4081 |
Epoetin alfa, 100 units esrd |
1,302 |
316 |
$102K |
| S9339 |
Hit periton dialysis diem |
115 |
78 |
$86K |
| J0882 |
Darbepoetin alfa, esrd use |
1,003 |
273 |
$84K |
| 0003A |
|
17 |
17 |
$680.00 |
| 90756 |
|
19 |
19 |
$465.08 |
| 90658 |
|
13 |
13 |
$295.10 |
| 85045 |
|
25 |
25 |
$7.02 |
| 84520 |
|
35 |
12 |
$6.24 |
| 84100 |
|
13 |
13 |
$4.17 |
| 82565 |
|
13 |
12 |
$0.00 |
| 84155 |
|
25 |
25 |
$0.00 |
| 82310 |
|
13 |
13 |
$0.00 |
| 84075 |
|
25 |
25 |
$0.00 |
| 82040 |
|
13 |
13 |
$0.00 |
| 80051 |
|
12 |
12 |
$0.00 |