WAL-MART STORES EAST LP
Community/Retail Pharmacy · LEBANON, IN
Organization Active NPI 1760409072
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 240 | 831 | $61,239 | $59,013 | $59,013 |
| 2023 | 265 | 869 | $51,125 | $49,666 | $49,666 |
| 2022 | 292 | 963 | $30,823 | $29,585 | $29,585 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 218 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 212 | $81 | $81 |
| 90480 | Admn sarscov2 vacc 1 dose | 171 | $13 | $13 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 108 | $155 | $155 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 53 | $146 | $146 |
| G0009 | Administration of pneumococcal vaccine | 26 | $20 | $20 |
| 90684 | Pcv21 vaccine im | 13 | $321 | $321 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 13 | $290 | $290 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | 60005044 | IN |
| 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.