CVS STATE CAPITAL LLC
Pharmacy · PORTLAND, ME
Organization Active NPI 1134223050
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 268 | 855 | $70,221 | $67,303 | $67,303 |
| 2023 | 322 | 1,692 | $56,291 | $51,564 | $51,564 |
| 2022 | 422 | 2,173 | $44,149 | $39,540 | $39,540 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 255 | $42 | $42 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 249 | $146 | $146 |
| G0008 | Administration of influenza virus vaccine | 168 | $30 | $30 |
| 90662 | Influenza vaccine split virus, preservative free | 73 | $82 | $82 |
| 90653 | Influenza vaccine, inactivated | 68 | $82 | $82 |
| 90673 | Influenza vaccine, trivalent derived from recombinant dna | 12 | $82 | $82 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | PH50000256 | ME |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | — | — |
Other Pharmacy providers in Maine
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.