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2010 HCPCS Schedule - DE Medical Assistance Program

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87177 OVA AND PARASITES SMEARS 3 $12.49<br />

87178 MICROBIAL I<strong>DE</strong>NTIFICATION, NUCLEIC A O $0.00<br />

87179 MICROBIAL I<strong>DE</strong>NTIFICATION, NUCLEIC A O $0.00<br />

87181 MICROBE SUSCEPTIBLE, DIFFUSE 3 $6.66<br />

87184 MICROBE SUSCEPTIBLE, DISK 3 $9.68<br />

87185 MICROBE SUSCEPTIBLE, ENZYME 3 $6.66<br />

87186 MICROBE SUSCEPTIBLE, MIC 3 $12.13<br />

87187 MICROBE SUSCEPTIBLE, MLC 3 $14.54<br />

87188 MICROBE SUSCEPT, MACROBROTH 3 $9.01<br />

87190 MICROBE SUSCEPT, MYCOBACTERI 3 $7.94<br />

87192 ANTIBIOTIC SENSITIVITY, EACH O $0.00<br />

87197 BACTERICIDAL LEVEL, SERUM 3 $16.32<br />

87198 CYTOMEGALOVIRUS ANTIBODY DFA O $0.00<br />

87199 ENTEROVIRUS ANTIBODY, DFA O $0.00<br />

87205 SMEAR, GRAM STAIN 3 $5.99<br />

87206 SMEAR, FLUORESCENT/ACID STAI 3 $6.79<br />

87207 SMEAR, SPECIAL STAIN 3 $8.09<br />

87208 SMEAR, STAIN & INTERPRET O $0.00<br />

87209 SMEAR, COMPLEX STAIN 3 $24.29<br />

87210 SMEAR, WET MOUNT, SALINE/INK 3 $5.99<br />

87211 SMEAR, STAIN & INTERPRET O $0.00<br />

87220 TISSUE EXAM FOR FUNGI 3 $4.85<br />

87230 ASSAY, TOXIN OR ANTITOXIN 3 $24.49<br />

87250 VIRUS INOCULATE, EGGS/ANIMAL 3 $27.45<br />

87252 VIRUS INOCULATION, TISSUE 3 $36.58<br />

87253 VIRUS INOCULATE TISSUE, ADDL 3 $28.35<br />

87254 VIRUS INOCULATION, SHELL VIA 3 $27.45<br />

87255 GENET VIRUS ISOLATE, HSV 3 $47.53<br />

87260 A<strong>DE</strong>NOVIRUS AG, IF 3 $15.45<br />

87265 PERTUSSIS AG, IF 3 $15.45<br />

87267 ENTEROVIRUS ANTIBODY, DFA 3 $15.45<br />

87269 GIARDIA AG, IF 3 $15.45<br />

87270 CHLAMYDIA TRACHOMATIS AG, IF 3 $15.45<br />

87271 CYTOMEGALOVIRUS DFA 3 $15.45<br />

87272 CRYPTOSPORIDIUM AG, IF 3 $15.45<br />

87273 HERPES SIMPLEX 2, AG, IF 3 $15.45<br />

87274 HERPES SIMPLEX 1, AG, IF 3 $15.45<br />

87275 INFLUENZA B, AG, IF 3 $15.45<br />

87276 INFLUENZA A, AG, IF 3 $15.45<br />

87277 LEGIONELLA MICDA<strong>DE</strong>I, AG, IF 3 $15.45<br />

87278 LEGION PNEUMOPHILIA AG, IF 3 $15.45<br />

87279 PARAINFLUENZA, AG, IF 3 $15.45<br />

87280 RESPIRATORY SYNCYTIAL AG, IF 3 $15.45<br />

87281 PNEUMOCYSTIS CARINII, AG, IF 3 $15.45<br />

87283 RUBEOLA, AG, IF 3 $15.45<br />

87285 TREPONEMA PALLIDUM, AG, IF 3 $15.45<br />

87290 VARICELLA ZOSTER, AG, IF 3 $15.45<br />

87299 ANTIBODY <strong>DE</strong>TECTION, NOS, IF 3 $15.45<br />

87300 AG <strong>DE</strong>TECTION, POLYVAL, IF 3 $15.45

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