| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
3,036 |
1,387 |
$202K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
10,303 |
4,437 |
$50K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,502 |
1,096 |
$41K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
6,604 |
3,955 |
$36K |
| A4670 |
Automatic blood pressure monitor |
828 |
828 |
$32K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
751 |
599 |
$22K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
10,669 |
6,651 |
$21K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
17,055 |
5,971 |
$16K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
577 |
385 |
$13K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
288 |
180 |
$9K |
| J7599 |
Immunosuppressive drug, not otherwise classified |
73 |
56 |
$4K |
| E0570 |
Nebulizer, with compressor |
76 |
76 |
$4K |
| A4259 |
Lancets, per box of 100 |
795 |
555 |
$3K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
4,906 |
2,995 |
$637.00 |
| A4663 |
Blood pressure cuff only |
13 |
13 |
$80.45 |