INNOVATIVE DIALYSIS CENTER OF WEST LOS ANGELES, LLC

$8.76M

Total Medicaid Paid

97,982

Total Claims

26,474

Beneficiaries

44

Codes Billed

2018-01

First Month

2024-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
90999		45,986	3,727	$8.22M
J1756	Iron sucrose injection	2,248	593	$179K
J0887	Epoetin beta esrd use	1,354	842	$139K
J2501	Paricalcitol	9,138	799	$85K
J0604	Cinacalcet, esrd on dialysis	1,144	204	$82K
A4657	Syringe w/wo needle	10,618	1,110	$15K
83970		1,123	1,065	$6K
80051		1,069	1,005	$5K
85018		3,382	1,136	$4K
84466		1,307	1,170	$3K
84075		1,389	1,312	$2K
82728		1,290	1,210	$2K
84520		2,488	1,142	$2K
85025		1,380	1,299	$2K
A6402	Sterile gauze <= 16 sq in	255	27	$1K
83540		1,463	1,318	$1K
82040		1,325	1,118	$1K
82310		1,411	1,203	$996.04
84100		1,584	1,167	$990.69
84155		1,361	1,280	$929.86
82565		1,267	1,138	$896.35
Q4081	Epoetin alfa, 100 units esrd	695	89	$835.50
J1644	Inj heparin sodium per 1000u	2,086	173	$672.82
90732		14	13	$291.43
82374		123	107	$273.29
84132		127	108	$258.87
85014		253	225	$237.57
82306		144	140	$180.87
87340		215	207	$85.72
84295		108	105	$81.09
82108		124	121	$78.10
82746		142	138	$76.12
82607		143	140	$73.67
90686		12	12	$61.38
82435		108	105	$57.34
G0008	Admin influenza virus vac	25	25	$51.65
86706		103	102	$44.70
84450		393	383	$39.05
83735		116	113	$32.31
86803		19	19	$12.44
83550		159	149	$2.90
80069		95	87	$1.11
0250		163	15	$0.00
83036		33	33	$0.00

Medicaid Provider Spending