WAL-MART STORES EAST LP
Community/Retail Pharmacy · PORTAGE, WI
Organization Active NPI 1265459317
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 363 | 1,312 | $99,124 | $95,884 | $95,884 |
| 2023 | 400 | 1,324 | $86,031 | $83,715 | $83,715 |
| 2022 | 619 | 1,844 | $56,254 | $54,006 | $54,006 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 323 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 305 | $82 | $82 |
| 90480 | Admn sarscov2 vacc 1 dose | 278 | $10 | $10 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 166 | $158 | $158 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 104 | $148 | $148 |
| G0009 | Administration of pneumococcal vaccine | 55 | $23 | $23 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 33 | $292 | $292 |
| 90684 | Pcv21 vaccine im | 21 | $321 | $321 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | 8184-42 | WI |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Pharmacy | 333600000X | — | — | |
| Specialty Pharmacy | 3336S0011X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.