| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7507 |
Tacrolimus, immediate release, oral, 1 mg |
13,207 |
11,062 |
$255K |
| J7518 |
Mycophenolic acid, oral, 180 mg |
3,772 |
3,258 |
$241K |
| J7517 |
Mycophenolate mofetil, oral, 250 mg |
7,473 |
6,670 |
$154K |
| Q0511 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period |
11,022 |
10,194 |
$29K |
| Q0512 |
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period |
20,510 |
10,423 |
$29K |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
7,655 |
6,983 |
$28K |
| J7515 |
Cyclosporine, oral, 25 mg |
399 |
354 |
$10K |
| J7520 |
Sirolimus, oral, 1 mg |
29 |
26 |
$2K |
| Q0510 |
Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant |
91 |
91 |
$340.00 |
| J7500 |
Azathioprine, oral, 50 mg |
32 |
24 |
$143.21 |