CVS STATE CAPITAL LLC
Pharmacy · WINDHAM, ME
Organization Active NPI 1063516987
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 311 | 992 | $81,341 | $78,915 | $78,915 |
| 2023 | 362 | 2,446 | $51,899 | $48,485 | $48,485 |
| 2022 | 553 | 2,880 | $53,818 | $48,031 | $48,031 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 246 | $42 | $42 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 244 | $150 | $150 |
| G0008 | Administration of influenza virus vaccine | 230 | $30 | $30 |
| 90662 | Influenza vaccine split virus, preservative free | 119 | $82 | $82 |
| 90653 | Influenza vaccine, inactivated | 103 | $82 | $82 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 20 | $291 | $291 |
| G0009 | Administration of pneumococcal vaccine | 20 | $30 | $30 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | PH50000166 | ME |
| 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.