MOUNTAIN LAKE PHARMACY INC
Community/Retail Pharmacy · SUMMERSVILLE, WV
Organization Active NPI 1336228006
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 12 | 24 | $1,996 | $1,539 | $1,539 |
| 2022 | 11 | 22 | $3,030 | $891 | $891 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90653 | Influenza vaccine, inactivated | 11 | $82 | $82 |
| G0008 | Administration of influenza virus vaccine | 11 | $29 | $29 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | SP0552314 | WV |
| Pharmacy | 333600000X | — | — |
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See all Community/Retail Pharmacy providers in West Virginia →
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.