QUEENS DEVELOPMENT CORPORATION & SUBSIDIARIES
NPI: 1003984246
· HONOLULU, HI 96813
· Community/Retail Pharmacy
· NPI assigned 12/04/2006
$381.41
Total Medicaid Paid
Provider Details
| Authorized Official | SANJUME, GAVIN (DIR, RETAIL & CONTRCT PHCY) |
| NPI Enumeration Date | 12/04/2006 |
Related Entities
Other providers sharing the same authorized official: SANJUME, GAVIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
215 |
$381.41 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
16 |
12 |
$288.87 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
162 |
85 |
$60.47 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
37 |
36 |
$32.07 |