POLE MOUNTAIN PHARMACY LLC
Community/Retail Pharmacy · LARAMIE, WY
Organization Active NPI 1013422971
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 607 | 2,166 | $194,572 | $173,250 | $173,250 |
| 2023 | 734 | 2,374 | $165,175 | $153,100 | $153,100 |
| 2022 | 833 | 2,287 | $114,398 | $94,568 | $94,568 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 547 | $42 | $42 |
| G0008 | Administration of influenza virus vaccine | 499 | $31 | $31 |
| 90662 | Influenza vaccine split virus, preservative free | 477 | $82 | $82 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 435 | $154 | $154 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 112 | $143 | $143 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 37 | $290 | $290 |
| G0009 | Administration of pneumococcal vaccine | 37 | $32 | $32 |
| 90656 | Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage | 17 | $22 | $22 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | R10169 | WY |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.