fee schedule 2009 new - DE Medical Assistance Program

78601 3 BRAIN IMAGE W/FLOW < 4 VIEWS 199.11
78605 3 BRAIN IMAGE 4+ VIEWS 190.05
78606 3 BRAIN IMAGE W/FLOW 4 + VIEWS 276.93
78607 3 BRAIN IMAGING (3D) 360.70
78608 3 BRAIN IMAGING (PET) 323.62
78609 3 BRAIN IMAGING (PET) 323.62
78610 3 BRAIN FLOW IMAGING ONLY 180.08
78615 O CEREBRAL VASCULAR FLOW IMAGE 0.00
78630 3 CEREBROSPINAL FLUID SCAN 305.81
78635 3 CSF VENTRICULOGRAPHY 253.33
78645 3 CSF SHUNT EVALUATION 238.22
78647 3 CEREBROSPINAL FLUID SCAN 331.14
78650 3 CSF LEAKAGE IMAGING 292.78
78652 O CSF LEAKAGE DETECTION AND LOCALIZAT 0.00
78655 O RADIOPHARMACEUTICAL IDENTIFICATION 0.00
78660 3 NUCLEAR EXAM OF TEAR FLOW 151.29
78699 5 NERVOUS SYSTEM NUCLEAR EXAM 0.00
78700 3 KIDNEY IMAGING, MORPHOL 170.24
78701 3 KIDNEY IMAGING WITH FLOW 201.88
78704 O IMAGING RENOGRAM 0.00
78707 3 K FLOW/FUNCT IMAGE W/O DRUG 242.95
78708 3 K FLOW/FUNCT IMAGE W/DRUG 213.94
78709 3 K FLOW/FUNCT IMAGE, MULTIPLE 328.20
78710 3 KIDNEY IMAGING (3D) 257.05
78715 O RENAL VASCULAR FLOW EXAM 0.00
78725 3 KIDNEY FUNCTION STUDY 100.75
78726 O KIDNEY FUNCTION STUDY INCLUDING PHA 0.00
78727 O KIDNEY TRANSPLANT EVALUATION 0.00
78730 3 URINARY BLADDER RETENTION 78.00
78740 3 URETERAL REFLUX STUDY 180.28
78760 O TESTICULAR IMAGING 0.00
78761 3 TESTICULAR IMAGING W/FLOW 197.00
78799 5 GENITOURINARY NUCLEAR EXAM 0.00
78800 3 TUMOR IMAGING, LIMITED AREA 185.83
78801 3 TUMOR IMAGING, MULT AREAS 242.29
78802 3 TUMOR IMAGING, WHOLE BODY 313.95
78803 3 TUMOR IMAGING (3D) 353.32
78804 3 TUMOR IMAGING, WHOLE BODY 563.24
78805 3 ABSCESS IMAGING, LTD AREA 185.87
78806 3 ABSCESS IMAGING, WHOLE BODY 337.46
78807 3 NUCLEAR LOCALIZATION/ABSCESS 352.64
78808 6 IV INJ RA DRUG DX STUDY 0.00
78810 O TUMOR IMAGING (PET) 0.00
78811 3 PET IMAGE, LTD AREA 1,460.39
78812 3 PET IMAGE, SKULL-THIGH 1,907.10
78813 3 PET IMAGE, FULL BODY 1,994.19
78814 3 PET IMAGE W/CT, LMTD 2,226.60
78815 3 PET IMAGE W/CT, SKULL-THIGH 2,501.95
78816 3 PET IMAGE W/CT, FULL BODY 2,570.73
78890 O NUCLEAR MEDICINE DATA PROC 0.00