CVS STATE CAPITAL LLC
NPI: 1003004938
· LEWISTON, ME 04240
· Community/Retail Pharmacy
· NPI assigned 10/04/2007
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official COLBERT, SUSAN controls 20+ related entities in our dataset. Read more
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | COLBERT, SUSAN (SR. DIRECTOR) |
| NPI Enumeration Date | 10/04/2007 |
Related Entities
Other providers sharing the same authorized official: COLBERT, SUSAN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
15 |
$0.00 |
| 2019 |
40 |
$0.00 |
| 2020 |
27 |
$0.00 |
| 2021 |
17 |
$0.00 |
| 2022 |
41 |
$0.00 |
| 2023 |
26 |
$0.00 |
| 2024 |
44 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Administration of influenza virus vaccine |
97 |
97 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
38 |
38 |
$0.00 |
| 90480 |
|
15 |
15 |
$0.00 |
| 0124A |
|
15 |
15 |
$0.00 |
| 90662 |
|
13 |
13 |
$0.00 |
| 0004A |
|
17 |
17 |
$0.00 |
| 91320 |
|
15 |
15 |
$0.00 |