J7507 Tacrolimus imme rel oral 1mgTacrolimus, immediate release, oral, 1 mg
J7507 payment limit: $0.162 per 1 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
00469-0607-73 Prograf, Astellas Pharma US, Inc.: 50 billing units per package (1 BOTTLE in 1 CARTON / 100 CAPSULE, GELATIN COATED in 1 BOTTLE)00469-0617-73 Prograf, Astellas Pharma US, Inc.: 100 billing units per package (1 BOTTLE in 1 CARTON / 100 CAPSULE, GELATIN COATED in 1 BOTTLE)00469-0657-73 Prograf, Astellas Pharma US, Inc.: 500 billing units per package (1 BOTTLE in 1 CARTON / 100 CAPSULE, GELATIN COATED in 1 BOTTLE)82009-0164-01 Tacolimus, Quallent Pharmaceuticals: 50 billing units per package (100 CAPSULE in 1 BOTTLE)50090-5581-00 Tacrolimus, A-S Medication Solutions: 90 billing units per package (90 CAPSULE in 1 BOTTLE)50090-5596-00 Tacrolimus, A-S Medication Solutions: 90 billing units per package (90 CAPSULE in 1 BOTTLE)16729-0041-01 Tacrolimus, Accord Healthcare Inc: 50 billing units per package (100 CAPSULE in 1 BOTTLE)16729-0042-01 Tacrolimus, Accord Healthcare Inc: 100 billing units per package (100 CAPSULE in 1 BOTTLE)16729-0043-01 Tacrolimus, Accord Healthcare Inc: 500 billing units per package (100 CAPSULE in 1 BOTTLE)68084-0449-01 Tacrolimus, American Health Packaging: 50 billing units per package (100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER PACK)68084-0450-01 Tacrolimus, American Health Packaging: 100 billing units per package (100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER PACK)68084-0451-01 Tacrolimus, American Health Packaging: 500 billing units per package (100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER PACK)67877-0278-01 Tacrolimus, Ascend Laboratories, LLC: 50 billing units per package (100 CAPSULE in 1 BOTTLE)67877-0279-01 Tacrolimus, Ascend Laboratories, LLC: 100 billing units per package (100 CAPSULE in 1 BOTTLE)67877-0280-01 Tacrolimus, Ascend Laboratories, LLC: 500 billing units per package (100 CAPSULE in 1 BOTTLE)70377-0014-11 Tacrolimus, Biocon Pharma Inc: 50 billing units per package (100 CAPSULE in 1 BOTTLE)70377-0015-11 Tacrolimus, Biocon Pharma Inc: 100 billing units per package (100 CAPSULE in 1 BOTTLE)70377-0016-11 Tacrolimus, Biocon Pharma Inc: 500 billing units per package (100 CAPSULE in 1 BOTTLE)72572-0760-01 Tacrolimus, Civica, Inc.: 50 billing units per package72572-0761-01 Tacrolimus, Civica, Inc.: 100 billing units per package55111-0525-01 Tacrolimus, Dr. Reddy's Laboratories Inc.: 50 billing units per package (1 BOTTLE in 1 CARTON / 100 CAPSULE in 1 BOTTLE)55111-0526-01 Tacrolimus, Dr. Reddy's Laboratories Inc.: 100 billing units per package (1 BOTTLE in 1 CARTON / 100 CAPSULE in 1 BOTTLE)55111-0527-01 Tacrolimus, Dr. Reddy's Laboratories Inc.: 500 billing units per package (1 BOTTLE in 1 CARTON / 100 CAPSULE in 1 BOTTLE)68462-0685-01 Tacrolimus, Glenmark Pharmaceuticals Inc., USA: 50 billing units per package (100 CAPSULE in 1 BOTTLE)68462-0686-01 Tacrolimus, Glenmark Pharmaceuticals Inc., USA: 100 billing units per package (100 CAPSULE in 1 BOTTLE)68462-0687-01 Tacrolimus, Glenmark Pharmaceuticals Inc., USA: 500 billing units per package (100 CAPSULE in 1 BOTTLE)00904-7097-61 Tacrolimus, Major Pharmaceuticals: 100 billing units per package (100 BLISTER PACK in 1 CARTON / 1 CAPSULE in 1 BLISTER PACK)00378-2045-01 Tacrolimus, Mylan Pharmaceuticals Inc.: 50 billing units per package (100 CAPSULE in 1 BOTTLE, PLASTIC)00378-2046-01 Tacrolimus, Mylan Pharmaceuticals Inc.: 100 billing units per package (100 CAPSULE in 1 BOTTLE, PLASTIC)00378-2047-01 Tacrolimus, Mylan Pharmaceuticals Inc.: 500 billing units per package (100 CAPSULE in 1 BOTTLE, PLASTIC)16714-0098-01 Tacrolimus, Northstar RxLLC: 50 billing units per package (100 CAPSULE in 1 BOTTLE)16714-0099-01 Tacrolimus, Northstar RxLLC: 100 billing units per package (100 CAPSULE in 1 BOTTLE)16714-0100-01 Tacrolimus, Northstar RxLLC: 500 billing units per package (100 CAPSULE in 1 BOTTLE)82009-0054-01 Tacrolimus, Quallent Pharmaceuticals: 100 billing units per package (100 CAPSULE in 1 BOTTLE)00781-2102-01 Tacrolimus, Sandoz Inc.: 50 billing units per package (100 CAPSULE in 1 BOTTLE)00781-2103-01 Tacrolimus, Sandoz Inc.: 100 billing units per package (100 CAPSULE in 1 BOTTLE)00781-2104-01 Tacrolimus, Sandoz Inc.: 500 billing units per package (100 CAPSULE in 1 BOTTLE)64380-0720-06 Tacrolimus, Strides Pharma Science Limited: 50 billing units per package (100 CAPSULE in 1 CONTAINER)64380-0721-06 Tacrolimus, Strides Pharma Science Limited: 100 billing units per package (100 CAPSULE in 1 CONTAINER)64380-0722-06 Tacrolimus, Strides Pharma Science Limited: 500 billing units per package (100 CAPSULE in 1 CONTAINER)Status E: excluded from the PFS by regulation.
0 of 1 payer prior-auth lists that name J7507 require prior authorization or set conditions.
J7507 appears in 8 coverage policies from Aetna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Dry Eyes (0457) | not covered | Jul 29, 2026 | payer document |
| Aetna | Eculizumab (0807) | listed, no stance | Aug 11, 2026 | payer document |
| Aetna | Erectile Dysfunction and Peyronie's Disease (0007) | not covered | Jul 29, 2026 | payer document |
| Aetna | Fetal Echocardiography and Magnetocardiography (0106) | listed, no stance | Mar 26, 2026 | payer document |
| Aetna | Inebilizumab-cdon (Uplizna) (0975) | listed, no stance | Aug 11, 2026 | payer document |
| Aetna | Nipocalimab-aahu (Imaavy) (1083) | listed, no stance | Aug 11, 2026 | payer document |
| Aetna | Ravulizumab-cwvz (Ultomiris) (0946) | listed, no stance | Aug 11, 2026 | payer document |
| Aetna | Rozanolixizumab-noli (Rystiggo) (1035) | listed, no stance | Aug 11, 2026 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.