fee schedule 2009 new - DE Medical Assistance Program

A9260 9 NON-CERTIFIED PHYSICAL THERAPISTS 0.00
A9270 9 NON-COVERED ITEM OR SERVICE 0.00
A9274 6 EXT AMB INSULIN DELIVERY SYS 0.00
A9275 9 DISP HOME GLUCOSE MONITOR 0.00
A9276 9 DISPOSABLE SENSOR, CGM SYS 0.00
A9277 9 EXTERNAL TRANSMITTER, CGM 0.00
A9278 9 EXTERNAL RECEIVER, CGM SYS 0.00
A9279 9 MONITORING FEATURE/DEVICENOC 0.00
A9280 6 ALERT OR ALARM DEVICE, NOC 0.00
A9281 9 REACHING/GRABBING DEVICE 0.00
A9282 9 WIG ANY TYPE 0.00
A9283 6 FOOT PRESS OFF LOAD SUPP DEV 0.00
A9284 9 NON-ELECTRONIC SPIROMETER 0.00
A9290 9 DESCRIPTION OF SERVICE DOES NOT IND 0.00
A9300 O EXERCISE EQUIPMENT 0.00
A9500 9 TC99M SESTAMIBI 0.00
A9501 9 TECHNETIUM TC-99M TEBOROXIME 0.00
A9502 9 TC99M TETROFOSMIN 0.00
A9503 9 TC99M MEDRONATE 0.00
A9504 9 TC99M APCITIDE 0.00
A9505 9 TL201 THALLIUM 0.00
A9507 9 IN111 CAPROMAB 0.00
A9508 9 I131 IODOBENGUATE, DX 0.00
A9509 9 IODINE I-123 SOD IODIDE MIL 0.00
A9510 9 TC99M DISOFENIN 0.00
A9511 O TECHNETIUM TC 99M DEPREOTIDE 0.00
A9512 9 TC99M PERTECHNETATE 0.00
A9513 O TECHNETIUM TC-99M MEBROFENIN 0.00
A9514 O TECHNETIUMTC99MPYROPHOSPHATE 0.00
A9515 O TECHNETIUM TC-99M PENTETATE 0.00
A9516 9 IODINE I-123 SOD IODIDE MIC 0.00
A9517 9 I131 IODIDE CAP, RX 0.00
A9518 O I-131 SODIUM IODIDE SOLUTION 0.00
A9519 O TECHNETIUMTC-99MMACROAG ALBU 0.00
A9520 O TECHNETIUMTC-99M SULFUR CLLD 0.00
A9521 9 TC99M EXAMETAZIME 0.00
A9522 O INDIUM111IBRITUMOMABTIUXETAN 0.00
A9523 O YTTRIUM90IBRITUMOMABTIUXETAN 0.00
A9524 9 I131 SERUM ALBUMIN, DX 0.00
A9525 O LOW/ISO-OSMOLAR CONTRAST MAT 0.00
A9526 9 NITROGEN N-13 AMMONIA 0.00
A9527 9 IODINE I-125 SODIUM IODIDE 0.00
A9528 9 IODINE I-131 IODIDE CAP, DX 0.00
A9529 9 I131 IODIDE SOL, DX 0.00
A9530 9 I131 IODIDE SOL, RX 0.00
A9531 9 I131 MAX 100UCI 0.00
A9532 9 I125 SERUM ALBUMIN, DX 0.00
A9533 O I-131 TOSITUMOMAB DIAGNOSTIC 0.00
A9534 O I-131 TOSITUMOMAB THERAPEUT 0.00
A9535 9 INJECTION, METHYLENE BLUE 0.00