HERITAGE DIALYSIS CENTER LLC

$1.89M

Total Medicaid Paid

86,841

Total Claims

35,732

Beneficiaries

42

Codes Billed

2018-01

First Month

2024-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
90999		37,835	3,057	$1.89M
90756		75	68	$76.14
G0008	Admin influenza virus vac	75	68	$45.00
84520		4,487	1,926	$0.00
85014		276	270	$0.00
82565		2,010	1,888	$0.00
J1756	Iron sucrose injection	3,970	1,019	$0.00
83540		2,019	1,911	$0.00
82310		2,260	1,907	$0.00
84155		1,834	1,725	$0.00
J0882	Darbepoetin alfa, esrd use	689	229	$0.00
84100		2,469	1,911	$0.00
J0887	Epoetin beta esrd use	1,399	843	$0.00
84450		1,812	1,712	$0.00
J1644	Inj heparin sodium per 1000u	5,705	465	$0.00
84460		1,445	1,355	$0.00
84295		68	64	$0.00
83970		814	754	$0.00
J2916	Na ferric gluconate complex	697	213	$0.00
J7030	Normal saline solution infus	1,553	609	$0.00
84466		372	362	$0.00
82108		151	147	$0.00
82374		67	64	$0.00
80076		126	125	$0.00
83550		1,647	1,549	$0.00
A4657	Syringe w/wo needle	1,848	1,755	$0.00
84075		1,827	1,725	$0.00
83615		371	362	$0.00
82040		1,955	1,715	$0.00
87340		1,076	985	$0.00
85018		607	299	$0.00
80051		1,922	1,813	$0.00
85025		370	360	$0.00
82306		304	300	$0.00
84132		227	100	$0.00
86706		117	109	$0.00
82728		1,945	1,820	$0.00
82435		67	64	$0.00
J0606	Inj, etelcalcetide, 0.1 mg	290	24	$0.00
0011A		18	18	$0.00
0012A		15	15	$0.00
86803		27	27	$0.00

Medicaid Provider Spending