fee schedule 2009 new - DE Medical Assistance Program

A4772 9 BLOOD GLUCOSE TEST STRIPS 0.00
A4773 9 OCCULT BLOOD TEST STRIPS 0.00
A4774 9 AMMONIA TEST STRIPS 0.00
A4780 9 ESRD STERILIZING AGENT 0.00
A4790 9 ESRD CLEANSING AGENTS 0.00
A4800 9 HEPARIN/ANTIDOTE DIALYSIS 0.00
A4801 9 HEPARIN PER 1000 UNITS 0.00
A4802 9 PROTAMINE SULFATE PER 50 MG 0.00
A4820 9 SUPPLIES HEMODIALYSIS KIT 0.00
A4850 9 RUBBER TIPPED HEMOSTATS 0.00
A4860 9 DISPOSABLE CATHETER TIPS 0.00
A4870 9 PLUMB/ELEC WK HM HEMO EQUIP 0.00
A4880 9 WATER STORAGE TANKS 0.00
A4890 9 REPAIR/MAINT CONT HEMO EQUIP 0.00
A4900 9 CAPD SUPPLY KIT 0.00
A4901 9 CCPD SUPPLY KIT 0.00
A4905 9 IPD SUPPLY KIT 0.00
A4910 9 ESRD NONMEDICAL SUPPLIES 0.00
A4911 9 DRAIN BAG/BOTTLE 0.00
A4912 9 GOMCO DRAIN BOTTLE 0.00
A4913 9 MISC DIALYSIS SUPPLIES NOC 0.00
A4914 9 PREPARATION KIT 0.00
A4918 9 VENOUS PRESSURE CLAMP 0.00
A4919 9 SUPP DIALYSIS DIALYZER HOLDE 0.00
A4920 9 HARVARD PRESSURE CLAMP 0.00
A4921 9 MEASURING CYLINDER 0.00
A4927 3 NON-STERILE GLOVES 6.19
A4928 9 SURGICAL MASK 0.00
A4929 9 TOURNIQUET FOR DIALYSIS, EA 0.00
A4930 3 STERILE, GLOVES PER PAIR 0.44
A4931 9 REUSABLE ORAL THERMOMETER 0.00
A4932 9 REUSABLE RECTAL THERMOMETER 0.00
A5051 3 POUCH CLSD W BARR ATTACHED 2.21
A5052 3 CLSD OSTOMY POUCH W/O BARR 1.59
A5053 3 CLSD OSTOMY POUCH FACEPLATE 1.66
A5054 3 CLSD OSTOMY POUCH W/FLANGE 1.37
A5055 3 STOMA CAP 1.35
A5061 3 POUCH DRAINABLE W BARRIER AT 2.58
A5062 3 DRNBLE OSTOMY POUCH W/O BARR 2.12
A5063 3 DRAIN OSTOMY POUCH W/FLANGE 2.09
A5064 O DRAIN OSTOMY POUCH W/FCEPLTE 0.00
A5065 O DRAIN OSTOMY POUCH ON FCPLTE 0.00
A5071 3 URINARY POUCH W/BARRIER 4.15
A5072 3 URINARY POUCH W/O BARRIER 3.36
A5073 3 URINARY POUCH ON BARR W/FLNG 3.04
A5074 O URINARY POUCH W/FACEPLATE 0.00
A5075 O URINARY POUCH ON FACEPLATE 0.00
A5081 3 CONTINENT STOMA PLUG 3.14
A5082 3 CONTINENT STOMA CATHETER 11.34
A5083 6 STOMA ABSORPTIVE COVER 0.00