| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0584 |
Injection, burosumab-twza 1m |
4,457 |
1,983 |
$57.37M |
| J3316 |
Inj., triptorelin xr 3.75 mg |
437 |
378 |
$6.47M |
| J3590 |
Unclassified biologics |
44 |
25 |
$511K |
| Q0512 |
Px sup fee anti-can sub pres |
4,767 |
2,545 |
$177K |
| J7503 |
Tacrol envarsus ex rel oral |
846 |
770 |
$127K |
| Q0511 |
Sup fee antiem,antica,immuno |
2,847 |
2,646 |
$110K |
| J7518 |
Mycophenolic acid |
1,284 |
1,128 |
$86K |
| J7507 |
Tacrolimus imme rel oral 1mg |
1,779 |
1,335 |
$59K |
| J7517 |
Mycophenolate mofetil oral |
1,500 |
1,236 |
$9K |
| J7508 |
Tacrol astagraf ex rel oral |
115 |
69 |
$9K |
| J7512 |
Prednisone ir or dr oral 1mg |
1,520 |
1,381 |
$4K |
| Q0510 |
Dispens fee immunosupressive |
30 |
22 |
$880.77 |