WAL-MART STORES EAST LP
Community/Retail Pharmacy · PORTALES, NM
Organization Active NPI 1609893759
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 220 | 674 | $50,694 | $49,278 | $49,278 |
| 2023 | 245 | 693 | $45,828 | $44,514 | $44,514 |
| 2022 | 430 | 1,024 | $50,119 | $48,226 | $48,226 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 161 | $12 | $12 |
| G0008 | Administration of influenza virus vaccine | 155 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 143 | $81 | $81 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 135 | $157 | $157 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 26 | $144 | $144 |
| G0009 | Administration of pneumococcal vaccine | 21 | $24 | $24 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 18 | $291 | $291 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | PH00001925 | NM |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Pharmacy | 333600000X | — | — |
Other Community/Retail Pharmacy providers in New Mexico
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.