Supplier
Raina RX LLC
Raina RX LLC was paid $78K by Medicaid between Jun 2024 and Oct 2024, across 2 billing codes. Its largest line is J0585, Injection, onabotulinumtoxina, 1 unit — 100% of everything it billed.
33Billing provider infoRAINA RX LLC
NEWBURGH, NY 12550
NEWBURGH, NY 12550
33aNPI1164881942assigned 02/22/2016
33bProvider typeCommunity/Retail Pharmacy
28Total paid$78K
24GClaims116
24DCodes billed2
24AFirst – last monthJun 2024 – Oct 2024
Compared with peers
Next to other Community/Retail Pharmacy providers in New York
Rank by total paid#29 of 129
Median peer was paid$2K
This provider vs. median38×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2024incomplete | 116 | $78K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 100% | 95 | 94 | $78K |
| S9542 | Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem | 0% | 21 | 21 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMONTANEZ, ELVIN (COO)
| Provider | Location | Paid |
|---|---|---|
| Bioplus Specialty Pharmacy Services, LLC | Altamonte Springs, FL | $58K |
| Dogwood Pharmacy, LLC | Greenville, SC | $9K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.