WAL-MART STORES EAST LP
Community/Retail Pharmacy · VIDALIA, GA
Organization Active NPI 1588681993
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 88 | 236 | $18,440 | $17,893 | $17,893 |
| 2023 | 118 | 349 | $18,010 | $17,311 | $17,311 |
| 2022 | 327 | 2,042 | $31,567 | $30,613 | $30,613 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 72 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 62 | $81 | $81 |
| 90480 | Admn sarscov2 vacc 1 dose | 26 | $17 | $17 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 20 | $292 | $292 |
| G0009 | Administration of pneumococcal vaccine | 20 | $20 | $20 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 15 | $146 | $146 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 11 | $151 | $151 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | PHRE006544 | GA |
| 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.