NPI: 1699868380 · SHIPSHEWANA, IN 46565 · Durable Medical Equipment & Medical Supplies · NPI assigned 10/02/2006
| Authorized Official | BALLOU, JARED (OWNER) |
| NPI Enumeration Date | 10/02/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 145 | $671.28 |
| 2019 | 42 | $227.27 |
| 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 | 100 | 72 | $594.45 |
| 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 | 87 | 60 | $304.10 |