Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

5 MINUTE PHARMACY SBC

NPI: 1477224137 · HONOLULU, HI 96817 · Community/Retail Pharmacy · NPI assigned 09/22/2021

$461K
Total Medicaid Paid
11,782
Total Claims
6,900
Beneficiaries
9
Codes Billed
2023-11
First Month
2024-12
Last Month

Provider Details

Authorized OfficialTENGAN, DEREK (MANAGER)
NPI Enumeration Date09/22/2021

Related Entities

Other providers sharing the same authorized official: TENGAN, DEREK

ProviderCityStateTotal Paid
OUTREACH MEDICAL GROUP DOWNTOWN LLC HONOLULU HI $15K
5 MINUTE PHARMACY LTC LLC WAIPAHU HI $11K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 2,168 $88K
2024 9,614 $373K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1502 Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit 5,514 3,538 $461K
J0401 Injection, aripiprazole (abilify maintena), 1 mg 1,671 937 $7.01
J2794 Injection, risperidone (risperdal consta), 0.5 mg 101 37 $0.00
J2427 Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg 305 181 $0.00
J2798 Injection, risperidone, (perseris), 0.5 mg 225 130 $0.00
J3490 Unclassified drugs 24 14 $0.00
J1631 Injection, haloperidol decanoate, per 50 mg 279 122 $0.00
J1944 Injection, aripiprazole lauroxil, (aristada), 1 mg 723 367 $0.00
J2426 Injection, paliperidone palmitate extended release (invega sustenna), 1 mg 2,940 1,574 $0.00