| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4105 |
In-line cartridge containing digestive enzyme(s) for enteral feeding, each |
977 |
918 |
$6.29M |
| Z5999 |
|
5,582 |
4,771 |
$739K |
| J7639 |
Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
1,080 |
827 |
$557K |
| J7131 |
Hypertonic saline solution, 1 ml |
11,120 |
10,471 |
$547K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
13,144 |
10,644 |
$170K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
7,572 |
6,884 |
$130K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
2,292 |
2,093 |
$123K |
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
977 |
651 |
$79K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
11,799 |
11,344 |
$61K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
12,699 |
10,822 |
$59K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
807 |
780 |
$55K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,613 |
955 |
$36K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
6,541 |
5,895 |
$20K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
395 |
366 |
$4K |
| J7520 |
Sirolimus, oral, 1 mg |
59 |
50 |
$4K |
| A4208 |
Syringe with needle, sterile 3 cc, each |
884 |
828 |
$4K |
| A4215 |
Needle, sterile, any size, each |
40 |
39 |
$2K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
161 |
154 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
553 |
511 |
$1K |
| J7515 |
Cyclosporine, oral, 25 mg |
29 |
25 |
$474.26 |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
47 |
40 |
$61.87 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
44 |
41 |
$44.33 |