| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7518 |
Mycophenolic acid, oral, 180 mg |
1,853 |
1,763 |
$83K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
4,885 |
3,907 |
$81K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
1,795 |
1,639 |
$41K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
4,752 |
4,527 |
$7K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
2,896 |
2,662 |
$6K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
6,534 |
4,213 |
$6K |
| 0011A |
|
193 |
193 |
$0.00 |
| 0012A |
|
176 |
175 |
$0.00 |
| 0001A |
|
47 |
47 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
85 |
83 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 0013A |
|
40 |
40 |
$0.00 |
| 0002A |
|
31 |
31 |
$0.00 |