WAL-MART STORES EAST LP
Community/Retail Pharmacy · AVA, MO
Organization Active NPI 1558389056
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 93 | 302 | $21,190 | $20,568 | $20,568 |
| 2023 | 107 | 349 | $25,506 | $24,805 | $24,805 |
| 2022 | 147 | 388 | $12,566 | $12,277 | $12,277 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 87 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 84 | $82 | $82 |
| 90480 | Admn sarscov2 vacc 1 dose | 54 | $11 | $11 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 27 | $152 | $152 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 27 | $156 | $156 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | 2002009527 | MO |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Pharmacy | 333600000X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.