Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - NORTHEAST, LLC

NPI: 1992175459 · ERIE, PA 16505 · Prosthetic/Orthotic Supplier · NPI assigned 09/28/2015

$11K
Total Medicaid Paid
191
Total Claims
144
Beneficiaries
4
Codes Billed
2021-06
First Month
2024-09
Last Month

Provider Details

Authorized OfficialBETANCOURT, ALEX (MANAGER)
Parent OrganizationPEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - NORTHEAST, LLC
NPI Enumeration Date09/28/2015

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 26 $1K
2023 140 $8K
2024 25 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
L2275 Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined 92 54 $6K
L4386 Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise 27 27 $2K
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf 51 51 $2K
L2270 Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad 21 12 $399.02