1629059647

1629059647 was paid $133K by Medicaid between Jan 2018 and Nov 2019, across 7 billing codes. Its largest line is L4361, Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf — 60% of everything it billed.

33Billing provider info1629059647

33aNPI1629059647

33bProvider type—

28Total paid$133K

24GClaims2,435

24DCodes billed7

24AFirst – last monthJan 2018 – Nov 2019

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	1,492	$67K
2019	943	$66K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	60%	1,167	837	$79K
L3670	Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf	20%	261	254	$27K
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	7.8%	688	515	$10K
E0114	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	5.4%	167	163	$7K
L1902	Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf	3.7%	108	106	$5K
L1833	Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf	3.2%	25	12	$4K
L3809	Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type	<1%	19	12	$43.95

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.