DIALYSIS NEWCO LLC

$5.60M

Total Medicaid Paid

110,669

Total Claims

35,613

Beneficiaries

45

Codes Billed

2018-01

First Month

2024-09

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
90999		33,849	2,744	$5.53M
J0887	Epoetin beta esrd use	1,811	1,082	$24K
A4657	Syringe w/wo needle	18,726	1,682	$19K
J2501	Paricalcitol	9,104	820	$9K
J1756	Iron sucrose injection	3,946	900	$7K
85014		4,641	1,788	$3K
84132		336	203	$2K
80051		1,685	1,646	$851.76
84075		1,873	1,826	$617.23
J1644	Inj heparin sodium per 1000u	2,797	227	$552.70
90674		27	27	$375.03
85018		4,638	1,788	$358.24
83970		846	803	$344.65
84466		2,035	1,821	$288.62
0011A		37	32	$196.42
85025		1,878	1,819	$177.90
82310		3,047	1,827	$174.90
G0008	Admin influenza virus vac	48	48	$157.23
84520		4,186	1,825	$151.83
83540		2,036	1,821	$147.87
0012A		32	31	$123.69
90688		14	14	$122.36
84100		2,580	1,832	$108.20
82728		632	607	$98.76
82565		1,865	1,818	$89.27
J0604	Cinacalcet, esrd on dialysis	71	12	$87.62
82040		1,905	1,784	$85.82
84155		1,841	1,793	$73.62
87340		320	300	$45.82
84450		894	878	$33.80
82374		242	199	$25.29
82306		172	162	$24.54
84295		187	178	$22.21
82435		187	178	$21.29
82108		156	148	$19.52
82607		177	167	$13.20
82746		177	167	$12.94
86706		177	167	$9.41
83735		175	165	$5.90
86803		61	60	$1.93
91301		49	43	$0.06
Q4081	Epoetin alfa, 100 units esrd	948	114	$0.00
0250		233	39	$0.00
J3490	Drugs unclassified injection	14	14	$0.00
0013A		14	14	$0.00

Medicaid Provider Spending