| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
268 |
242 |
$16K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
521 |
494 |
$2K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
327 |
298 |
$2K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
985 |
633 |
$1K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
593 |
553 |
$108.73 |