| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7518 |
Mycophenolic acid, oral, 180 mg |
1,697 |
1,334 |
$108K |
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
466 |
359 |
$36K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,129 |
1,042 |
$30K |
| A4215 |
Needle, sterile, any size, each |
672 |
633 |
$30K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
1,479 |
1,227 |
$12K |
| E0607 |
Home blood glucose monitor |
232 |
231 |
$6K |
| A4259 |
Lancets, per box of 100 |
617 |
596 |
$6K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
67 |
67 |
$2K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
2,151 |
1,874 |
$1K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
3,122 |
1,833 |
$695.74 |
| S8490 |
Insulin syringes (100 syringes, any size) |
14 |
14 |
$372.45 |
| Q0510 |
Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant |
125 |
122 |
$320.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,113 |
1,049 |
$240.32 |