NPI: 1770621922 · ALEXANDRIA, LA 71301 · Prosthetic/Orthotic Supplier · NPI assigned 02/01/2007
| Authorized Official | LUTFALLAH, CESAR (OWNER-PRESIDENT) |
| NPI Enumeration Date | 02/01/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 55 | $1K |
| 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 | 28 | 14 | $735.42 |
| 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 | 27 | 12 | $299.40 |