| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrol envarsus ex rel oral |
8,913 |
5,347 |
$1.37M |
| J7507 |
Tacrolimus imme rel oral 1mg |
5,498 |
3,732 |
$141K |
| J7517 |
Mycophenolate mofetil oral |
6,187 |
5,283 |
$119K |
| J7518 |
Mycophenolic acid |
2,351 |
1,856 |
$118K |
| Q0511 |
Sup fee antiem,antica,immuno |
7,856 |
7,494 |
$40K |
| Q0512 |
Px sup fee anti-can sub pres |
12,285 |
6,391 |
$28K |
| J8521 |
Capecitabine, oral, 500 mg |
206 |
150 |
$19K |
| S5000 |
Prescription drug, generic |
249 |
195 |
$13K |
| J7500 |
Azathioprine oral 50mg |
198 |
152 |
$6K |
| J7512 |
Prednisone ir or dr oral 1mg |
6,640 |
5,532 |
$6K |
| A4253 |
Blood glucose/reagent strips |
13 |
12 |
$873.55 |