| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7503 |
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg |
2,957 |
2,444 |
$465K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
4,672 |
4,465 |
$216K |
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
8,397 |
7,371 |
$115K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
4,537 |
4,323 |
$59K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
9,982 |
9,568 |
$25K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
16,604 |
9,514 |
$20K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
6,208 |
5,943 |
$8K |
| J3490 |
Unclassified drugs |
203 |
151 |
$3K |
| Q0510 |
Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant |
24 |
14 |
$31.20 |
| E1399 |
Durable medical equipment, miscellaneous |
75 |
29 |
$0.00 |