| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrol envarsus ex rel oral |
3,036 |
1,387 |
$202K |
| J7507 |
Tacrolimus imme rel oral 1mg |
10,303 |
4,437 |
$50K |
| A4253 |
Blood glucose/reagent strips |
1,502 |
1,096 |
$41K |
| J7517 |
Mycophenolate mofetil oral |
6,604 |
3,955 |
$36K |
| A4670 |
Automatic bp monitor, dial |
828 |
828 |
$32K |
| A4239 |
Non-adju cgm supply allow |
751 |
599 |
$22K |
| Q0511 |
Sup fee antiem,antica,immuno |
10,669 |
6,651 |
$21K |
| Q0512 |
Px sup fee anti-can sub pres |
17,055 |
5,971 |
$16K |
| J7518 |
Mycophenolic acid |
577 |
385 |
$13K |
| K0553 |
Ther cgm supply allowance |
288 |
180 |
$9K |
| J7599 |
Immunosuppressive drug noc |
73 |
56 |
$4K |
| E0570 |
Nebulizer with compression |
76 |
76 |
$4K |
| A4259 |
Lancets per box |
795 |
555 |
$3K |
| J7512 |
Prednisone ir or dr oral 1mg |
4,906 |
2,995 |
$637.00 |
| A4663 |
Dialysis blood pressure cuff |
13 |
13 |
$80.45 |