SOUTH STREET PHARMACY, LLC
Pharmacy · WHEATLAND, WY
Organization Active NPI 1639482532
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 104 | 222 | $19,953 | $17,506 | $17,506 |
| 2023 | 98 | 195 | $11,396 | $10,370 | $10,370 |
| 2022 | 169 | 360 | $15,654 | $14,572 | $14,572 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 82 | $29 | $29 |
| 90662 | Influenza vaccine split virus, preservative free | 69 | $82 | $82 |
| G0009 | Administration of pneumococcal vaccine | 29 | $31 | $31 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 28 | $286 | $286 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | R10063 | WY |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.