NPI: 1508821117 · VIRGINIA BEACH, VA 23455 · Prosthetic/Orthotic Supplier · NPI assigned 04/18/2006
| Authorized Official | MONTAGNA, LUCIAN (PRESIDENT) |
| NPI Enumeration Date | 04/18/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 15 | $372.92 |
| 2019 | 20 | $672.12 |
| 2022 | 15 | $864.40 |
| 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 | 50 | 38 | $2K |