| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
8,913 |
5,347 |
$1.37M |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
5,498 |
3,732 |
$141K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
6,187 |
5,283 |
$119K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
2,351 |
1,856 |
$118K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
7,856 |
7,494 |
$40K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
12,285 |
6,391 |
$28K |
| J8521 |
Capecitabine, oral, 500 mg |
206 |
150 |
$19K |
| S5000 |
Prescription drug, generic |
249 |
195 |
$13K |
| J7500 |
Azathioprine, oral, 50 mg |
198 |
152 |
$6K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
6,640 |
5,532 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
12 |
$873.55 |