NPI: 1518494772 · ERIE, PA 16502 · Prosthetic/Orthotic Supplier · NPI assigned 05/18/2017
| Authorized Official | MOSS, ANN (PRESIDENT) |
| NPI Enumeration Date | 05/18/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 39 | $561.15 |
| 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 | 20 | 15 | $357.24 |
| A5514 | For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 | 19 | 14 | $203.91 |