| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrol envarsus ex rel oral |
2,957 |
2,444 |
$465K |
| J7518 |
Mycophenolic acid |
4,672 |
4,465 |
$216K |
| J7507 |
Tacrolimus imme rel oral 1mg |
8,397 |
7,371 |
$115K |
| J7517 |
Mycophenolate mofetil oral |
4,537 |
4,323 |
$59K |
| Q0511 |
Sup fee antiem,antica,immuno |
9,982 |
9,568 |
$25K |
| Q0512 |
Px sup fee anti-can sub pres |
16,604 |
9,514 |
$20K |
| J7512 |
Prednisone ir or dr oral 1mg |
6,208 |
5,943 |
$8K |
| J3490 |
Drugs unclassified injection |
203 |
151 |
$3K |
| Q0510 |
Dispens fee immunosupressive |
24 |
14 |
$31.20 |
| E1399 |
Durable medical equipment mi |
75 |
29 |
$0.00 |