PACIFIC FOOTWEAR COMPANY, INC.
NPI: 1558316851
· PORTLAND, OR 97223
· 335E00000X
$4.26M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13,482 |
$746K |
| 2019 |
15,338 |
$716K |
| 2020 |
13,627 |
$552K |
| 2021 |
12,622 |
$508K |
| 2022 |
12,516 |
$538K |
| 2023 |
12,512 |
$596K |
| 2024 |
13,125 |
$607K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A5500 |
Diab shoe for density insert |
40,786 |
29,060 |
$1.58M |
| A5513 |
Multi den insert custom mold |
24,728 |
19,767 |
$1.46M |
| L1902 |
Afo ankle gauntlet pre ots |
10,404 |
6,543 |
$722K |
| A5514 |
Mult den insert dir carv/cam |
14,102 |
6,641 |
$234K |
| L5000 |
Sho insert w arch toe filler |
851 |
703 |
$182K |
| K0903 |
Mult den insert dir carv/cam |
1,318 |
1,243 |
$47K |
| A5512 |
Multi den insert direct form |
1,033 |
844 |
$38K |