1043615867

1043615867 was paid $514K by Medicaid between Jan 2018 and Sep 2022, across 17 billing codes. Its largest line is L3030, Foot, insert, removable, formed to patient foot, each — 21% of everything it billed.

33Billing provider info1043615867

33aNPI1043615867

33bProvider type—

28Total paid$514K

24GClaims14,443

24DCodes billed17

24AFirst – last monthJan 2018 – Sep 2022

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	1,068	$72K
2019	1,993	$88K
2020	3,704	$118K
2021	5,295	$159K
2022	2,383	$77K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
L3030	Foot, insert, removable, formed to patient foot, each	21%	2,229	1,400	$107K
L1906	Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf	14%	1,976	1,580	$72K
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	12%	2,231	2,228	$61K
L3002	Foot, insert, removable, molded to patient model, plastazote or equal, each	9.0%	838	649	$46K
T4523	Adult sized disposable incontinence product, brief/diaper, large, each	8.4%	549	548	$43K
T4539	Incontinence product, diaper/brief, reusable, any size, each	8.4%	1,541	1,541	$43K
T4522	Adult sized disposable incontinence product, brief/diaper, medium, each	5.8%	637	637	$30K
A4554	Disposable underpads, all sizes	5.3%	801	799	$27K
L3050	Foot, arch support, removable, premolded, metatarsal, each	5.0%	1,466	852	$26K
T4537	Incontinence product, protective underpad, reusable, bed size, each	3.7%	545	545	$19K
L3216	Orthopedic footwear, ladies shoe, depth inlay, each	2.7%	298	204	$14K
L4396	Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise	2.5%	183	150	$13K

5 more codes

L3221	Orthopedic footwear, mens shoe, depth inlay, each	1.1%	111	$6K
L3224	Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)	<1%	181	$3K
A4927	Gloves, non-sterile, per 100	<1%	742	$3K
A6530	Gradient compression stocking, below knee, 18-30 mmhg, each	<1%	66	$959.82
L3225	Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)	<1%	49	$820.97

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.