| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
3,497 |
3,111 |
$8K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
2,848 |
2,770 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
191 |
180 |
$780.75 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
3,176 |
3,108 |
$328.98 |
| A4259 |
Lancets, per box of 100 |
81 |
79 |
$51.26 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
3,714 |
3,489 |
$37.92 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
6,223 |
3,370 |
$14.76 |