NPI: 1427148402 · SALT LAKE CITY, UT 84132 · Durable Medical Equipment & Medical Supplies
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 288 | $1K |
| 2019 | 41 | $0.00 |
| 2021 | 339 | $2K |
| 2022 | 353 | $2K |
| 2023 | 65 | $696.62 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| J7518 | Mycophenolic acid, oral, 180 mg | 167 | 146 | $6K |
| J7507 | Tacrolimus, immediate release, oral, 1 mg | 161 | 106 | $728.98 |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 104 | 88 | $213.05 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | 654 | 270 | $3.68 |