CHARLESTON BRACE COMPANY, LLC
NPI: 1063617629
· WALTERBORO, SC 29488
· Prosthetic/Orthotic Supplier
· NPI assigned 06/15/2007
$638.48
Total Medicaid Paid
Provider Details
| Authorized Official | JACKSON, NATHANIEL (OWNER) |
| Parent Organization | CHARLESTON BRACE COMPANY, LLC |
| NPI Enumeration Date | 06/15/2007 |
Related Entities
Other providers sharing the same authorized official: JACKSON, NATHANIEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
15 |
$638.48 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
15 |
13 |
$638.48 |