GENOA HEALTHCARE LLC SOS Verified
701 SHADOW LN STE 110, LAS VEGAS, NV 89106
NPI Number
1629219290
Practice location · View on Google Maps
SOS Verification: Verified
Entity Name: GENOA HEALTHCARE LLC
Entity Number: E0435782018-1
Entity Type: Foreign Limited-Liability Company
Entity Status: Active
Formation Date: 2018-09-14
Name Match: 95%
Registered Agent
Name: UNITED AGENT GROUP INC.
Type: Commercial Registered Agent
Address: 112 NORTH CURRY STREET, Carson City, NV, 89703
Officers / Principals
| Title | Name | Address | Status |
|---|---|---|---|
| Manager | Todd Gustin | 707 South Grady Way, Suite 400, Renton, WA | Active |
| Manager | Christopher Stidman | 707 South Grady Way, Suite 400, Renton, WA | Active |
Payments by Year
How much Medicaid paid this provider each year. Large jumps can indicate changes in practice volume or billing patterns.
| Year | Total Paid | % of Max |
|---|---|---|
| 2018 | $0 | |
| 2019 | $0 | |
| 2020 | $0 |
Procedure Code Breakdown
The specific medical services this provider billed Medicaid for. Each HCPCS/CPT code represents a different type of visit, test, or treatment.
| HCPCS Code | Description | Claims | Paid | % of Total | Avg per Claim |
|---|---|---|---|---|---|
| J7518 | Mycophenolic acid, oral, 180 mg | 493 | $0 | 0.0% | $0 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | 982 | $0 | 0.0% | $0 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | 2,419 | $0 | 0.0% | $0 |
| J7507 | Tacrolimus, immediate release, oral, 1 mg | 1,422 | $0 | 0.0% | $0 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 612 | $0 | 0.0% | $0 |