CVS STATE CAPITAL LLC
Pharmacy · BANGOR, ME
Organization Active NPI 1104848852
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 259 | 898 | $74,369 | $71,940 | $71,940 |
| 2023 | 647 | 5,089 | $124,949 | $119,325 | $119,325 |
| 2022 | 474 | 2,793 | $58,968 | $53,605 | $53,605 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 233 | $39 | $39 |
| G0008 | Administration of influenza virus vaccine | 198 | $30 | $30 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 191 | $153 | $153 |
| 90662 | Influenza vaccine split virus, preservative free | 126 | $82 | $82 |
| 90653 | Influenza vaccine, inactivated | 61 | $82 | $82 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 33 | $143 | $143 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 18 | $292 | $292 |
| G0009 | Administration of pneumococcal vaccine | 18 | $29 | $29 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | PH50001551 | ME |
Other Pharmacy providers in Maine
- NPI 1972029577
- NPI 1770758898
- NPI 1548785207
- NPI 1700300407
- NPI 1114255049
- NPI 1982485843
- NPI 1194038620
- NPI 1174006647
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.