| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7518 |
Mycophenolic acid, oral, 180 mg |
5,098 |
4,797 |
$26K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
9,604 |
7,592 |
$20K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
2,896 |
2,677 |
$13K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
10,147 |
9,697 |
$9K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
17,554 |
9,104 |
$6K |
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
1,029 |
683 |
$1K |
| J7515 |
Cyclosporine, oral, 25 mg |
275 |
257 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
6,740 |
6,315 |
$616.40 |
| J7520 |
Sirolimus, oral, 1 mg |
76 |
65 |
$0.00 |