DIALYSIS NEWCO LLC

$2.89M

Total Medicaid Paid

99,764

Total Claims

27,669

Beneficiaries

45

Codes Billed

2018-01

First Month

2024-01

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
J0887	Epoetin beta esrd use	1,673	928	$1.45M
90999		23,343	1,768	$1.11M
J0882	Darbepoetin alfa, esrd use	750	233	$278K
J1756	Iron sucrose injection	1,390	360	$43K
J0604	Cinacalcet, esrd on dialysis	630	86	$10K
A4657	Syringe w/wo needle	26,763	1,632	$246.43
J2501	Paricalcitol	7,333	556	$55.84
83036		132	117	$0.00
87340		777	689	$0.00
85025		1,737	1,531	$0.00
82728		617	544	$0.00
82435		280	239	$0.00
84075		1,745	1,539	$0.00
86706		225	201	$0.00
84132		337	254	$0.00
85018		3,630	1,500	$0.00
82607		177	158	$0.00
80051		577	524	$0.00
82040		1,168	852	$0.00
G0008	Admin influenza virus vac	34	31	$0.00
82306		171	148	$0.00
83550		333	271	$0.00
82746		177	158	$0.00
83735		178	158	$0.00
80069		215	188	$0.00
90674		18	18	$0.00
80048		12	12	$0.00
Q4081	Epoetin alfa, 100 units esrd	75	12	$0.00
84450		917	794	$0.00
84100		1,145	942	$0.00
85014		3,583	1,495	$0.00
82565		926	822	$0.00
83540		1,863	1,537	$0.00
84466		1,446	1,266	$0.00
82310		2,091	1,409	$0.00
84460		62	53	$0.00
84520		2,719	1,169	$0.00
82108		160	141	$0.00
84155		1,701	1,503	$0.00
J1644	Inj heparin sodium per 1000u	7,196	577	$0.00
82374		303	253	$0.00
84295		283	240	$0.00
83970		807	707	$0.00
82947		46	39	$0.00
84080		19	15	$0.00

Medicaid Provider Spending