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NPI 1982626891 · Lewiston, ID · Pharmacy
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Idaho Cvs Pharmacy LLC is a pharmacy provider located in Lewiston, Idaho. This profile covers 11 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Idaho Cvs Pharmacy LLC |
| Address | 1904 19th Avenue |
| City | Lewiston |
| State | ID |
| ZIP | 83501 |
| Taxonomy | Pharmacy |
| NPI Enumerated | July 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $72.1K |
| Medicaid | $770 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 91320 | This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL. | 150 | $130 | $19.3K |
| 90694 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL… | 250 | $80 | $19.3K |
| 91322 | This code represents a SARS–CoV–2 vaccine product administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 50 mcg/0.5 mL. | 80 | $140 | $10.9K |
| 90480 | The provider administers the first or only component of a SARS–CoV–2 (COVID–19) vaccine by intramuscular injection to reduce the patient's risk of contracting COVID–19. | 230 | $40 | $8.7K |
| G0008 | Administration of influenza virus vaccine | 280 | $20 | $5K |
| 90677 | This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the… | 20 | $280 | $4.2K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 240 | $10 | $2.4K |
| 0124A | N/A | 30 | $40 | $1.1K |
| 0134A | N/A | 10 | $40 | $530 |
| G0009 | Administration of pneumococcal vaccine | 20 | $30 | $420 |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
11 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 91322 | 63 | 140 | 70 | $140 | $244.4K |
| K1034 | 73 | 120 | 310 | $10 | $233.1K |
| 91320 | 33 | 140 | 60 | $130 | $231.6K |
| 90480 | 36 | 210 | 80 | $40 | $96K |
| 90677 | 107 | 160 | 20 | $280 | $81.2K |
| G0008 | 41 | 410 | 50 | $30 | $42.3K |
| 0134A | 48 | 70 | 20 | $40 | $40.4K |
| 0124A | 34 | 80 | 30 | $40 | $39.8K |
| G0009 | 118 | 170 | 20 | $30 | $8.8K |
| 90686 | 69 | 70 | 30 | $20 | $8.4K |
Showing 1–10 of 11
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 60 | $10 | $770 |
| 90653 | This code represents an inactivated influenza vaccine product that contains subunits of the virus and an adjuvant to enhance the immune response. The vaccine is administered via separately reportable… | 30 | $0 | $0 |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 10 | $0 | $0 |
| G0008 | Administration of influenza virus vaccine | 60 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 84 | 110 | 270 | $20 | $9K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 157 | 160 | 110 | $1 | $2K |
| G0008 | Administration of influenza virus vaccine | 29 | 100 | 30 | $1 | $230 |
| 90653 | This code represents an inactivated influenza vaccine product that contains subunits of the virus and an adjuvant to enhance the immune response. The vaccine is administered via separately reportable… | 4 | 10 | 30 | $1 | $20 |
Other providers in the same ZIP code as Idaho Cvs Pharmacy LLC, ranked by combined Medicare and Medicaid revenue.
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