Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NY › NEWBURGH › RAINA RX LLC

RAINA RX LLC

NPI: 1164881942 · NEWBURGH, NY 12550 · Community/Retail Pharmacy · NPI assigned 02/22/2016

$78K
Total Medicaid Paid
116
Total Claims
115
Beneficiaries
2
Codes Billed
2024-06
First Month
2024-10
Last Month

Provider Details

Authorized OfficialMONTANEZ, ELVIN (COO)
NPI Enumeration Date02/22/2016

Related Entities

Other providers sharing the same authorized official: MONTANEZ, ELVIN

ProviderCityStateTotal Paid
BIOPLUS SPECIALTY PHARMACY SERVICES, LLC ALTAMONTE SPRINGS FL $58K
DOGWOOD PHARMACY, LLC GREENVILLE SC $9K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 116 $78K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
J0585 Injection, onabotulinumtoxina, 1 unit 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 21 21 $0.00