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fee schedule 2009 new - DE Medical Assistance Program

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C1851 9 REPLIFORM 24/28 SQ CM 0.00<br />

C1852 9 TRANSCYTE, PER 247 SQ CM 0.00<br />

C1853 9 SUSPEND, PER 8/14 SQ CM 0.00<br />

C1854 9 SUSPEND, PER 24/28 SQ CM 0.00<br />

C1855 9 SUSPEND, PER 36 SQ CM 0.00<br />

C1856 9 SUSPEND, PER 48 SQ CM 0.00<br />

C1857 9 SUSPEND, PER 84 SQ CM 0.00<br />

C1858 9 DURA<strong>DE</strong>RM, PER 8/14 SQ CM 0.00<br />

C1859 9 DURA<strong>DE</strong>RM, PER 21/24/28 SQ CM 0.00<br />

C1860 9 DURA<strong>DE</strong>RM, PER 48 SQ CM 0.00<br />

C1861 9 DURA<strong>DE</strong>RM, PER 36 SQ CM 0.00<br />

C1862 9 DURA<strong>DE</strong>RM, PER 72 SQ CM 0.00<br />

C1863 9 DURA<strong>DE</strong>RM, PER 84 SQ CM 0.00<br />

C1864 9 SPERMATEX, PER 13.44 SQ CM 0.00<br />

C1865 9 FASLATA, PER 8/14 SQ CM 0.00<br />

C1866 9 FASLATA, PER 24/28 SQ CM 0.00<br />

C1867 9 FASLATA, PER 36/48 SQ CM 0.00<br />

C1868 9 FASLATA, PER 96 SQ CM 0.00<br />

C1869 9 GORE THYROPLASTY <strong>DE</strong>VICE 0.00<br />

C1870 9 <strong>DE</strong>RMMATRIX, PER 16 SQ CM 0.00<br />

C1871 9 <strong>DE</strong>RMMATRIX, 32 OR 64 SQ CM 0.00<br />

C1872 9 <strong>DE</strong>RMAGRAFT, PER 37.5 SQ CM 0.00<br />

C1873 9 BARD 3DMAX MESH 0.00<br />

C1874 9 STENT, COATED/COV W/<strong>DE</strong>L SYS 0.00<br />

C1875 9 STENT, COATED/COV W/O <strong>DE</strong>L SY 0.00<br />

C1876 9 STENT, NON-COA/NON-COV W/<strong>DE</strong>L 0.00<br />

C1877 9 STENT, NON-COAT/COV W/O <strong>DE</strong>L 0.00<br />

C1878 9 MATRL FOR VOCAL CORD 0.00<br />

C1879 O TISSUE MARKER, IMPLANTABLE 0.00<br />

C1880 9 VENA CAVA FILTER 0.00<br />

C1881 9 DIALYSIS ACCESS SYSTEM 0.00<br />

C1882 9 AICD, OTHER THAN SING/DUAL 0.00<br />

C1883 9 ADAPT/EXT, PACING/NEURO LEAD 0.00<br />

C1884 9 EMBOLIZATION PROTECT SYST 0.00<br />

C1885 9 CATH, TRANSLUMIN ANGIO LASER 0.00<br />

C1887 9 CATHETER, GUIDING 0.00<br />

C1888 9 ENDOVAS NON-CARDIAC ABL CATH 0.00<br />

C1891 9 INFUSION PUMP,NON-PROG, PERM 0.00<br />

C1892 9 INTRO/SHEATH,FIXED,PEEL-AWAY 0.00<br />

C1893 9 INTRO/SHEATH, FIXED,NON-PEEL 0.00<br />

C1894 9 INTRO/SHEATH, NON-LASER 0.00<br />

C1895 9 LEAD, AICD, ENDO DUAL COIL 0.00<br />

C1896 9 LEAD, AICD, NON SING/DUAL 0.00<br />

C1897 9 LEAD, NEUROSTIM TEST KIT 0.00<br />

C1898 9 LEAD, PMKR, OTHER THAN TRANS 0.00<br />

C1899 9 LEAD, PMKR/AICD COMBINATION 0.00<br />

C1900 9 LEAD, CORONARY VENOUS 0.00<br />

C1925 9 INJECTION, RISPERIDONE 0.00<br />

C1929 9 MAVERICK PTCA CATH 0.00<br />

C1930 9 COYOTE DIL CATH, 20/30/40MM 0.00

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