CVS STATE CAPITAL LLC
Pharmacy · PORTLAND, ME
Organization Active NPI 1881798700
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 118 | 372 | $30,938 | $30,024 | $30,024 |
| 2023 | 133 | 581 | $26,588 | $24,313 | $24,313 |
| 2022 | 170 | 552 | $15,162 | $12,793 | $12,793 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| 90480 | Admn sarscov2 vacc 1 dose | 103 | $42 | $42 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 102 | $152 | $152 |
| G0008 | Administration of influenza virus vaccine | 76 | $31 | $31 |
| 90662 | Influenza vaccine split virus, preservative free | 59 | $82 | $82 |
| 90661 | Influenza vaccine, trivalent derived from cell cultures | 11 | $36 | $36 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Pharmacy | 333600000X | ✓ | PH50000244 | ME |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Community/Retail Pharmacy | 3336C0003X | — | — |
Other Pharmacy providers in Maine
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- NPI 1154644623
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.