CVS STATE CAPITAL LLC
Pharmacy · SOUTH PORTLAND, ME
Organization Active NPI 1295757946
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 170 | 488 | $38,686 | $37,673 | $37,673 |
| 2023 | 253 | 1,010 | $44,408 | $42,468 | $42,468 |
| 2022 | 334 | 993 | $31,252 | $26,914 | $26,914 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 138 | $39 | $39 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 137 | $152 | $152 |
| G0008 | Administration of influenza virus vaccine | 104 | $31 | $31 |
| 90662 | Influenza vaccine split virus, preservative free | 66 | $82 | $82 |
| 90661 | Influenza vaccine, trivalent derived from cell cultures | 14 | $36 | $36 |
| 90653 | Influenza vaccine, inactivated | 12 | $82 | $82 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | PH50001549 | ME |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.