CVS STATE CAPITAL LLC

NPI: 1508960428 · WATERVILLE, ME 04901 · Durable Medical Equipment & Medical Supplies · NPI assigned 09/12/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official COLBERT, SUSAN controls 20+ related entities in our dataset. Read more

$93.19

Total Medicaid Paid

872

Total Claims

833

Beneficiaries

Codes Billed

2018-09

First Month

2024-02

Last Month

Provider Details

Authorized Official	COLBERT, SUSAN (DIRECTOR)
NPI Enumeration Date	09/12/2006

Other providers sharing the same authorized official: COLBERT, SUSAN

Provider	City	State	Total Paid
MONTANA CVS PHARMACY LLC	ANACONDA	MT	$15K
WISCONSIN CVS PHARMACY LLC	APPLETON	WI	$13K
WISCONSIN CVS PHARMACY LLC	GREEN BAY	WI	$10K
WISCONSIN CVS PHARMACY LLC	MILWAUKEE	WI	$5K
AMERICAN DRUG STORES DELAWARE LLC	FARGO	ND	$3K
WISCONSIN CVS PHARMACY LLC	WAUWATOSA	WI	$3K
WISCONSIN CVS PHARMACY LLC	KENOSHA	WI	$3K
WISCONSIN CVS PHARMACY LLC	CUDAHY	WI	$2K
WISCONSIN CVS PHARMACY LLC	JANESVILLE	WI	$938.31
CVS PHARMACY, INC.	BIG SPRING	TX	$900.03
GARFIELD BEACH CVS, L.L.C.	REDDING	CA	$493.69
HOOK-SUPERX LLC	TERRE HAUTE	IN	$424.35
WISCONSIN CVS PHARMACY LLC	GREEN BAY	WI	$310.51
GARFIELD BEACH CVS LLC	MISSION HILLS	CA	$301.55
GARFIELD BEACH CVS LLC	SAND CITY	CA	$210.35
GARFIELD BEACH CVS LLC	LOS ANGELES	CA	$173.03
GARFIELD BEACH CVS LLC	GARDENA	CA	$173.03
ARIZONA CVS STORES LLC	TUCSON	AZ	$118.58
GARFIELD BEACH CVS LLC	BURBANK	CA	$0.00
GARFIELD BEACH CVS LLC	SAN JOSE	CA	$0.00

Code	Description	Claims	Beneficiaries	Total Paid
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	12	12	$93.19
91320		19	19	$0.00
0002A		313	303	$0.00
90662		12	12	$0.00
0004A		35	35	$0.00
G0008	Administration of influenza virus vaccine	57	57	$0.00
0001A		405	376	$0.00
90480		19	19	$0.00