CVS STATE CAPITAL LLC

Pharmacy · WATERVILLE, ME

Organization Active NPI 1508960428

Medicare payment data Part B · 2024

YearBeneficiariesServicesSubmittedAllowedPaid
20243601,166$95,356$91,187$91,187
20234872,756$94,761$86,417$86,417
20225172,797$62,090$55,200$55,200

Top procedures (2024)

HCPCSDescriptionServicesAvg allowedAvg paid
90480Admn sarscov2 vacc 1 dose309$39$39
91320Sarscv2 vac 30mcg trs-suc im305$148$148
G0008Administration of influenza virus vaccine256$30$30
90662Influenza vaccine split virus, preservative free124$82$82
90653Influenza vaccine, inactivated108$82$82
G0009Administration of pneumococcal vaccine18$30$30
90677Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use17$292$292

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Pharmacy333600000XPH50000111ME
Durable Medical Equipment & Medical Supplies332B00000X
Community/Retail Pharmacy3336C0003X

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