WAL-MART STORES EAST LP
Community/Retail Pharmacy · JACKSBORO, TN
Organization Active NPI 1215954490
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 80 | 254 | $19,264 | $18,757 | $18,757 |
| 2023 | 111 | 448 | $22,684 | $22,151 | $22,151 |
| 2022 | 208 | 997 | $22,042 | $21,391 | $21,391 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 73 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 69 | $82 | $82 |
| 90480 | Admn sarscov2 vacc 1 dose | 38 | $9 | $9 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 29 | $158 | $158 |
| G0009 | Administration of pneumococcal vaccine | 16 | $23 | $23 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 14 | $290 | $290 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | C2167 | TN |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Pharmacy | 333600000X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.