CVS STATE CAPITAL LLC
Pharmacy · CAPE ELIZABETH, ME
Organization Active NPI 1407950322
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 272 | 914 | $76,307 | $74,388 | $74,388 |
| 2023 | 411 | 2,824 | $68,315 | $65,429 | $65,429 |
| 2022 | 499 | 2,730 | $56,328 | $49,636 | $49,636 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 258 | $42 | $42 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 201 | $153 | $153 |
| G0008 | Administration of influenza virus vaccine | 186 | $30 | $30 |
| 90662 | Influenza vaccine split virus, preservative free | 126 | $82 | $82 |
| 90653 | Influenza vaccine, inactivated | 54 | $82 | $82 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 50 | $143 | $143 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 13 | $291 | $291 |
| G0009 | Administration of pneumococcal vaccine | 13 | $30 | $30 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | PH50000108 | ME |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.