| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7518 |
Mycophenolic acid |
2,161 |
1,928 |
$98K |
| J7517 |
Mycophenolate mofetil oral |
4,878 |
4,322 |
$88K |
| J7507 |
Tacrolimus imme rel oral 1mg |
9,829 |
7,228 |
$81K |
| J7503 |
Tacrol envarsus ex rel oral |
597 |
452 |
$67K |
| Q0511 |
Sup fee antiem,antica,immuno |
8,513 |
7,745 |
$29K |
| Q0512 |
Px sup fee anti-can sub pres |
11,930 |
7,491 |
$29K |
| J7512 |
Prednisone ir or dr oral 1mg |
5,728 |
5,168 |
$2K |
| J7500 |
Azathioprine oral 50mg |
14 |
12 |
$1K |
| J7515 |
Cyclosporine oral 25 mg |
41 |
37 |
$523.14 |
| Q0510 |
Dispens fee immunosupressive |
38 |
36 |
$110.00 |
| A4253 |
Blood glucose/reagent strips |
48 |
46 |
$106.73 |
| Q0513 |
Disp fee inhal drugs/30 days |
14 |
13 |
$59.40 |
| E1399 |
Durable medical equipment mi |
34 |
13 |
$0.00 |