| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
321 |
190 |
$765.33 |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
360 |
317 |
$500.41 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
1,045 |
930 |
$152.91 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
1,980 |
1,130 |
$148.49 |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
181 |
159 |
$39.44 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
220 |
203 |
$17.10 |