CVS STATE CAPITAL. L.L.C.
NPI: 1376793257
· AUGUSTA, ME 04330
· 332B00000X
$161.45
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
30 |
$161.45 |
| 2019 |
12 |
$0.00 |
| 2020 |
59 |
$0.00 |
| 2021 |
566 |
$0.00 |
| 2023 |
12 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
30 |
29 |
$161.45 |
| G0008 |
Admin influenza virus vac |
28 |
28 |
$0.00 |
| 0001A |
|
298 |
284 |
$0.00 |
| K1034 |
Covid test self-admn/collect |
12 |
12 |
$0.00 |
| 0002A |
|
311 |
304 |
$0.00 |