CVS STATE CAPITAL, L.L.C.
Pharmacy · FREEPORT, ME
Organization Active NPI 1376866830
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 400 | 1,294 | $107,024 | $104,450 | $104,450 |
| 2023 | 508 | 3,314 | $82,028 | $78,448 | $78,448 |
| 2022 | 625 | 3,792 | $71,455 | $64,352 | $64,352 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 369 | $39 | $39 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 349 | $154 | $154 |
| G0008 | Administration of influenza virus vaccine | 263 | $30 | $30 |
| 90653 | Influenza vaccine, inactivated | 150 | $82 | $82 |
| 90662 | Influenza vaccine split virus, preservative free | 96 | $82 | $82 |
| G0009 | Administration of pneumococcal vaccine | 15 | $29 | $29 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 15 | $290 | $290 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 12 | $153 | $153 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | — | — |
Other Pharmacy providers in Maine
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.