CVS STATE CAPITAL LLC

Pharmacy · SOUTH PORTLAND, ME

Organization Active NPI 1295757946

Medicare payment data Part B · 2024

YearBeneficiariesServicesSubmittedAllowedPaid
2024170488$38,686$37,673$37,673
20232531,010$44,408$42,468$42,468
2022334993$31,252$26,914$26,914

Top procedures (2024)

HCPCSDescriptionServicesAvg allowedAvg paid
90480Admn sarscov2 vacc 1 dose138$39$39
91322Sarscov2 vac 50 mcg/0.5ml im137$152$152
G0008Administration of influenza virus vaccine104$31$31
90662Influenza vaccine split virus, preservative free66$82$82
90661Influenza vaccine, trivalent derived from cell cultures14$36$36
90653Influenza vaccine, inactivated12$82$82

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Pharmacy333600000X
Durable Medical Equipment & Medical Supplies332B00000X
Community/Retail Pharmacy3336C0003XPH50001549ME

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.