FORT SMITH REGIONAL DIALYSIS CENTER LLC

$3.09M

Total Medicaid Paid

371,209

Total Claims

79,645

Beneficiaries

40

Codes Billed

2018-01

First Month

2024-11

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
J0887	Epoetin beta esrd use	11,375	5,386	$1.18M
90999		94,789	5,849	$481K
80053		6,380	4,906	$328K
83970		7,766	6,263	$223K
J0604	Cinacalcet, esrd on dialysis	585	438	$158K
J2501	Paricalcitol	41,964	3,761	$130K
J1756	Iron sucrose injection	19,346	4,065	$110K
J0882	Darbepoetin alfa, esrd use	1,253	324	$91K
85025		8,162	6,647	$51K
84520		10,717	5,965	$46K
87340		3,998	3,175	$45K
84450		1,708	1,653	$32K
A4209	5+ cc sterile syringe&needle	53,697	4,809	$29K
82728		2,551	2,082	$29K
84466		2,570	2,090	$26K
A4657	Syringe w/wo needle	13,514	3,143	$14K
82565		2,168	1,725	$13K
84132		1,714	1,657	$13K
90747		183	144	$11K
82374		1,707	1,653	$10K
84075		1,709	1,654	$10K
82435		1,707	1,653	$9K
84295		1,711	1,657	$9K
84155		1,710	1,656	$8K
J1644	Inj heparin sodium per 1000u	74,143	3,760	$5K
82108		660	532	$5K
82040		263	259	$3K
85018		871	769	$3K
82310		255	251	$2K
84100		263	259	$2K
90756		403	347	$2K
90732		54	46	$1K
83735		334	253	$1K
86704		136	105	$1K
90670		14	13	$873.04
83540		81	79	$767.00
G0008	Admin influenza virus vac	447	380	$488.91
G0010	Admin hepatitis b vaccine	186	144	$24.00
G0009	Admin pneumococcal vaccine	69	60	$24.00
90661		46	33	$0.00

Medicaid Provider Spending