SATELLITE DIALYSIS OF WHITE ROAD LLC

$3.74M

Total Medicaid Paid

147,821

Total Claims

42,484

Beneficiaries

44

Codes Billed

2018-01

First Month

2024-10

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
90999		52,770	4,382	$3.13M
J0882	Darbepoetin alfa, esrd use	11,105	2,797	$259K
J1756	Iron sucrose injection	5,320	2,329	$135K
Q4081	Epoetin alfa, 100 units esrd	8,984	975	$131K
A4657	Syringe w/wo needle	19,017	2,760	$40K
J1644	Inj heparin sodium per 1000u	2,044	176	$6K
83970		1,119	1,095	$4K
85018		634	413	$4K
0250		15,693	1,106	$3K
80051		2,375	2,338	$3K
85025		439	416	$2K
84466		1,404	1,383	$2K
84520		5,006	2,211	$1K
82728		1,111	1,094	$1K
83540		1,406	1,384	$1K
90677		26	26	$1K
84100		2,425	2,166	$904.02
J8499	Oral prescrip drug non chemo	511	38	$897.72
82310		2,377	2,133	$897.47
82040		2,362	2,163	$864.03
82565		2,227	2,177	$854.69
84075		2,265	2,211	$849.13
85045		2,465	2,417	$739.16
84155		2,231	2,185	$610.24
87340		405	378	$514.87
84450		192	185	$442.24
90688		74	73	$398.71
86706		271	266	$372.57
90694		49	49	$316.19
83036		47	46	$268.71
84132		717	385	$233.62
90662		33	33	$137.32
82746		48	47	$134.21
84545		42	40	$93.50
90653		16	16	$75.35
83735		48	47	$61.13
90756		13	13	$57.69
84540		126	123	$35.83
82607		41	41	$30.22
80048		47	47	$22.35
82435		107	101	$19.94
84295		86	81	$17.55
G0008	Admin influenza virus vac	56	56	$13.35
82374		87	82	$6.80

Medicaid Provider Spending