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    v1.0.28
    OpenPayerNPI Medicare & MedicaidPacific Footwear Company, Inc.
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    Pacific Footwear Company, Inc. — Billing Profile & Reimbursement Data

    NPI 1558316851 · Portland, OR · Customized Equipment (DME)

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    Pacific Footwear Company, Inc. is a customized equipment (dme) provider located in Portland, Oregon. This profile covers 0 Medicare and 7 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPacific Footwear Company, Inc.
    Address10240 Sw Nimbus Ave
    CityPortland
    StateOR
    ZIP97223
    TaxonomyCustomized Equipment (DME)
    NPI EnumeratedMay 24, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.3M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    7 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    A5500For 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 shoe40,790$40$1.6M
    A5513For 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…24,730$60$1.5M
    L1902Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf10,400$70$717.9K
    A5514For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot,…14,100$20$239.7K
    L5000Partial foot, shoe insert with longitudinal arch, toe filler850$210$182.1K
    K0903For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot,…1,320$40$47.4K
    A5512For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base…1,030$40$38.2K

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Oregon median

    7 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    L5000Partial foot, shoe insert with longitudinal arch, toe filler110850$210$182.2K
    A5513For 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…120260$60$114.4K
    L1902Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf11040$70$105.6K
    A5500For 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 shoe120150$40$91.9K
    A5514For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot,…110400$20$80.7K
    K0903For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot,…1101,320$40$47.1K
    A5512For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base…1101,030$40$38.3K

    Nearby Providers

    Other providers in the same ZIP code as Pacific Footwear Company, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    New NarrativeORMental Health Clinic/Center (Including Community Mental Health Center)$0$46.9M
    Children's Nursing Specialties, Inc.ORNursing Care Agency$0$18.9M
    Crc Health Oregon, LLCORMethadone Clinic$125.2K$14.5M
    Recovery Works Nw LLCORMulti-Specialty Clinic/Center$0$12.1M
    Neighborhood Health CenterORFederally Qualified Health Center (FQHC)$0$11.3M
    Maxim Healthcare Services, Inc.ORHome Health Agency$0$10.8M
    Sound Health Medical SupplyORDurable Medical Equipment & Medical Supplies$0$9.5M
    Aiden Healthcare LLCORCommunity Based Hospice Care Agency$0$5.9M
    Women's Healthcare Associates, LLCORSpecialist$0$5.6M
    Cynthia Gulick, PCORFamily Medicine Physician$0$3.9M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Oregon Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Oregon Distribution
    Pacific Footwear Company, Inc. — 4 of 7 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Oregon