DIALYSIS NEWCO LLC

$3.59M

Total Medicaid Paid

92,971

Total Claims

40,633

Beneficiaries

46

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
90999		24,592	2,360	$1.90M
J0887	Epoetin beta esrd use	2,034	1,267	$1.20M
90935		209	165	$287K
J1756	Iron sucrose injection	5,759	1,930	$169K
Q4081	Epoetin alfa, 100 units esrd	1,842	319	$40K
Q5105	Inj retacrit esrd on dialysi	64	12	$940.39
82306		171	138	$466.39
84450		2,041	1,746	$199.10
J0604	Cinacalcet, esrd on dialysis	136	48	$20.00
83540		2,563	1,993	$0.00
85014		2,474	1,793	$0.00
84100		2,850	1,878	$0.00
82108		200	164	$0.00
83970		1,432	1,141	$0.00
82565		2,174	1,757	$0.00
84295		400	319	$0.00
82310		2,572	1,926	$0.00
84466		2,152	1,699	$0.00
84155		2,460	1,971	$0.00
82374		465	351	$0.00
84520		3,496	1,900	$0.00
90661		19	17	$0.00
82040		2,234	1,760	$0.00
80051		1,596	1,300	$0.00
A4657	Syringe w/wo needle	8,977	1,939	$0.00
85025		2,501	1,999	$0.00
84075		2,501	2,004	$0.00
J2501	Paricalcitol	6,910	876	$0.00
82746		203	167	$0.00
90747		47	40	$0.00
82728		853	680	$0.00
G0008	Admin influenza virus vac	154	133	$0.00
87340		1,413	1,141	$0.00
83550		398	285	$0.00
83036		117	101	$0.00
85018		3,122	1,865	$0.00
80069		77	66	$0.00
84132		543	389	$0.00
82435		431	337	$0.00
83735		202	167	$0.00
86706		204	168	$0.00
90688		30	27	$0.00
82607		203	167	$0.00
J3490	Drugs unclassified injection	34	30	$0.00
90674		69	58	$0.00
G0010	Admin hepatitis b vaccine	47	40	$0.00

Medicaid Provider Spending