| 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 |
581 |
557 |
$192.00 |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
147 |
130 |
$153.74 |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
176 |
142 |
$107.12 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
763 |
381 |
$64.46 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
174 |
165 |
$8.10 |