WAL-MART STORES EAST LP
Community/Retail Pharmacy · JEFFERSON CITY, TN
Organization Active NPI 1760409940
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 173 | 548 | $38,164 | $37,283 | $37,283 |
| 2023 | 306 | 1,398 | $42,668 | $41,312 | $41,312 |
| 2022 | 719 | 3,204 | $61,405 | $58,929 | $58,929 |
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 | 140 | $81 | $81 |
| 90480 | Admn sarscov2 vacc 1 dose | 122 | $10 | $10 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 103 | $158 | $158 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 19 | $145 | $145 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | C2243 | TN |
| 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.