| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
2,059 |
1,423 |
$5K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
1,355 |
1,210 |
$4K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
4,096 |
1,908 |
$2K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
2,180 |
1,871 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,487 |
1,339 |
$195.30 |