CVS STATE CAPITAL LLC
Pharmacy · LEWISTON, ME
Organization Active NPI 1003004938
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 298 | 1,036 | $86,034 | $82,590 | $82,590 |
| 2023 | 488 | 2,972 | $95,792 | $87,960 | $87,960 |
| 2022 | 544 | 2,982 | $66,500 | $59,780 | $59,780 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 259 | $39 | $39 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 256 | $149 | $149 |
| G0008 | Administration of influenza virus vaccine | 230 | $30 | $30 |
| 90662 | Influenza vaccine split virus, preservative free | 200 | $82 | $82 |
| G0009 | Administration of pneumococcal vaccine | 29 | $28 | $28 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 27 | $290 | $290 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.