WAL-MART STORES EAST LP
Community/Retail Pharmacy · KOSCIUSKO, MS
Organization Active NPI 1720006257
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 176 | 508 | $37,728 | $36,934 | $36,934 |
| 2023 | 200 | 665 | $43,640 | $42,316 | $42,316 |
| 2022 | 322 | 1,166 | $33,666 | $32,066 | $32,066 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 145 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 130 | $81 | $81 |
| 90480 | Admn sarscov2 vacc 1 dose | 77 | $10 | $10 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 62 | $152 | $152 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 32 | $291 | $291 |
| G0009 | Administration of pneumococcal vaccine | 32 | $17 | $17 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 15 | $149 | $149 |
| 90673 | Influenza vaccine, trivalent derived from recombinant dna | 13 | $82 | $82 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | 04110 | MS |
| 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.