fee schedule 2009 new - DE Medical Assistance Program

A5093 3 OSTOMY ACCESSORY CONVEX INSE 1.85
A5102 3 BEDSIDE DRAIN BTL W/WO TUBE 21.39
A5105 3 URINARY SUSPENSORY 38.88
A5112 3 URINARY LEG BAG 28.07
A5113 3 LATEX LEG STRAP 4.48
A5114 3 FOAM/FABRIC LEG STRAP 8.52
A5119 O SKIN BARRIER WIPES BOX PR 50 0.00
A5120 3 SKIN BARRIER, WIPE OR SWAB 0.23
A5121 3 SOLID SKIN BARRIER 6X6 6.24
A5122 3 SOLID SKIN BARRIER 8X8 10.42
A5123 O SKIN BARRIER WITH FLANGE 0.00
A5126 3 DISK/FOAM PAD +OR- ADHESIVE 1.26
A5131 3 APPLIANCE CLEANER 15.13
A5149 O INCONTINENCE/OSTOMY SUPPLY 0.00
A5200 3 PERCUTANEOUS CATHETER ANCHOR 10.78
A5500 5 DIAB SHOE FOR DENSITY INSERT 0.00
A5501 5 DIABETIC CUSTOM MOLDED SHOE 0.00
A5502 9 DIABETIC SHOE DENSITY INSERT 0.00
A5503 5 DIABETIC SHOE W/ROLLER/ROCKR 0.00
A5504 5 DIABETIC SHOE WITH WEDGE 0.00
A5505 5 DIAB SHOE W/METATARSAL BAR 0.00
A5506 5 DIABETIC SHOE W/OFF SET HEEL 0.00
A5507 5 MODIFICATION DIABETIC SHOE 0.00
A5508 5 DIABETIC DELUXE SHOE 0.00
A5509 O DIRECT HEAT FORM SHOE INSERT 0.00
A5510 5 COMPRESSION FORM SHOE INSERT 0.00
A5511 O CUSTOM FAB MOLDED SHOE INSER 0.00
A5512 6 MULTI DEN INSERT DIRECT FORM 0.00
A5513 6 MULTI DEN INSERT CUSTOM MOLD 0.00
A6000 5 WOUND WARMING WOUND COVER 0.00
A6010 3 COLLAGEN BASED WOUND FILLER 30.62
A6011 3 COLLAGEN GEL/PASTE WOUND FIL 2.28
A6020 O COLLAGEN WOUND DRESSING 0.00
A6021 3 COLLAGEN DRESSING 648 SQ IN 181.51
A6024 3 COLLAGEN DSG WOUND FILLER 5.90
A6025 9 SILICONE GEL SHEET, EACH 0.00
A6154 9 WOUND POUCH EACH 0.00
A6196 3 ALGINATE DRESSING 16 48 SQ IN 15.68
A6199 3 ALGINATE DRSG WOUND FILLER 5.04
A6200 3 COMPOS DRSG 1648 NO BORDER 33.27
A6203 3 COMPOSITE DRSG 16 48 SQ IN 5.94
A6206 3 CONTACT LAYER