Revitalize Hydration Therapy, LLC

Revitalize Hydration Therapy, LLC was paid $192.08 by Medicaid between Oct 2024 and Oct 2024, across 1 billing code. Its largest line is 96365, Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour — 100% of everything it billed.

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	17	$192.08

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	100%	17	12	$192.08

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 officialMARDIS, JENNYE (STAFF)