Supplier
Pediatric Orthotic and Prosthetic Services- West, LLC
Pediatric Orthotic and Prosthetic Services- West, LLC was paid $79K by Medicaid between Mar 2018 and Apr 2023, across 4 billing codes. Its largest line is L1930, Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment — 49% of everything it billed.
33Billing provider infoPEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- WEST, LLC
SALT LAKE CITY, UT 84103
SALT LAKE CITY, UT 84103
33aNPI1225430150assigned 09/23/2014
33bProvider typeProsthetic/Orthotic Supplier
28Total paid$79K
24GClaims553
24DCodes billed4
24AFirst – last monthMar 2018 – Apr 2023
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 | 54 | $8K | |
| 2019 | 41 | $6K | |
| 2020 | 99 | $13K | |
| 2021 | 205 | $41K | |
| 2022 | 122 | $10K | |
| 2023 | 32 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| L1930 | Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment | 49% | 304 | 153 | $39K |
| L1960 | Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated | 45% | 113 | 67 | $35K |
| L2280 | Addition to lower extremity, molded inner boot | 4.7% | 111 | 56 | $4K |
| L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 1.2% | 25 | 13 | $973.55 |
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.
From NPPES
Who's on the registration
Authorized officialDRAPER, DAVID (DIRECTOR)
Parent organizationPEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- WEST, LLC