| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
4,159 |
3,165 |
$34K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
2,951 |
2,722 |
$34K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
3,887 |
3,622 |
$12K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
4,663 |
3,104 |
$8K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
365 |
338 |
$4K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,965 |
2,728 |
$989.51 |
| 99199 |
Unlisted special service, procedure or report |
42 |
33 |
$364.80 |