| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
920 |
858 |
$7K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
404 |
223 |
$7K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
844 |
493 |
$3K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
849 |
791 |
$2K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
14 |
12 |
$329.97 |
| 90480 |
|
13 |
13 |
$0.00 |
| 91322 |
|
13 |
13 |
$0.00 |
| 90653 |
|
13 |
13 |
$0.00 |