MAYO CLINIC ARIZONA
NPI: 1255796496
· PHOENIX, AZ 85054
· Pharmacy
· NPI assigned 12/15/2015
$983.50
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: DIDEHBAN, ROSHANAK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
16 |
$24.00 |
| 2019 |
14 |
$159.51 |
| 2022 |
26 |
$231.05 |
| 2023 |
128 |
$489.03 |
| 2024 |
17 |
$79.91 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
99 |
79 |
$590.44 |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
28 |
25 |
$212.58 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
57 |
48 |
$158.08 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
17 |
14 |
$22.40 |