NPI: 1407877335 · SAN RAFAEL, CA 94901 · Prosthetic/Orthotic Supplier · NPI assigned 07/23/2006
| Authorized Official | ALLEN, LESLIE (CFO) |
| NPI Enumeration Date | 07/23/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 30 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A5513 | For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each | 16 | 14 | $4K |
| 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 | 14 | 12 | $1K |