| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
1,233 |
1,128 |
$828.81 |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
1,515 |
1,449 |
$126.50 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
1,472 |
1,377 |
$100.71 |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
2,333 |
1,558 |
$9.84 |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
16 |
13 |
$0.00 |