fee schedule 2009 new - DE Medical Assistance Program

A9536 9 TC99M DEPREOTIDE 0.00
A9537 9 TC99M MEBROFENIN 0.00
A9538 9 TC99M PYROPHOSPHATE 0.00
A9539 9 TC99M PENTETATE 0.00
A9540 9 TC99M MAA 0.00
A9541 9 TC99M SULFUR COLLOID 0.00
A9542 9 IN111 IBRITUMOMAB, DX 0.00
A9543 9 Y90 IBRITUMOMAB, RX 0.00
A9544 9 I131 TOSITUMOMAB, DX 0.00
A9545 9 I131 TOSITUMOMAB, RX 0.00
A9546 9 CO57/58 0.00
A9547 9 IN111 OXYQUINOLINE 0.00
A9548 9 IN111 PENTETATE 0.00
A9549 O TC99M ARCITUMOMAB 0.00
A9550 9 TC99M GLUCEPTATE 0.00
A9551 9 TC99M SUCCIMER 0.00
A9552 9 F18 FDG 0.00
A9553 9 CR51 CHROMATE 0.00
A9554 9 I125 IOTHALAMATE, DX 0.00
A9555 9 RB82 RUBIDIUM 0.00
A9556 9 GA67 GALLIUM 0.00
A9557 9 TC99M BICISATE 0.00
A9558 9 XE133 XENON 10MCI 0.00
A9559 9 CO57 CYANO 0.00
A9560 9 TC99M LABELED RBC 0.00
A9561 9 TC99M OXIDRONATE 0.00
A9562 9 TC99M MERTIATIDE 0.00
A9563 9 P32 NA PHOSPHATE 0.00
A9564 9 P32 CHROMIC PHOSPHATE 0.00
A9565 O IN111 PENTETREOTIDE 0.00
A9566 9 TC99M FANOLESOMAB 0.00
A9567 9 TECHNETIUM TC-99M AEROSOL 0.00
A9568 9 TECHNETIUM TC99M ARCITUMOMAB 0.00
A9569 9 TECHNETIUM TC-99M AUTO WBC 0.00
A9570 9 INDIUM IN-111 AUTO WBC 0.00
A9571 9 INDIUM IN-111 AUTO PLATELET 0.00
A9572 9 INDIUM IN-111 PENTETREOTIDE 0.00
A9576 9 INJ PROHANCE MULTIPACK 0.00
A9577 9 INJ MULTIHANCE 0.00
A9578 9 INJ MULTIHANCE MULTIPACK 0.00
A9579 9 GAD-BASE MR CONTRAST NOS,1ML 0.00
A9580 9 SODIUM FLUORIDE F-18 0.00
A9600 9 SR89 STRONTIUM 0.00
A9603 9 I-131SODIUMIODIDECAP PER MCI 0.00
A9605 9 SM 153 LEXIDRONM 0.00
A9698 9 NON-RAD CONTRAST MATERIALNOC 0.00
A9699 9 RADIOPHARM RX AGENT NOC 0.00
A9700 9 ECHOCARDIOGRAPHY CONTRAST 0.00
A9900 5 SUPPLY/ACCESSORY/SERVICE 0.00
A9901 9 DELIVERY/SET UP/DISPENSING 0.00