fee schedule 2009 new - DE Medical Assistance Program

J1452 5 INTRAOCULAR FOMIVIRSEN NA 0.00
J1453 6 FOSAPREPITANT INJECTION 0.00
J1455 6 FOSCARNET SODIUM INJECTION 0.00
J1457 6 GALLIUM NITRATE INJECTION 0.00
J1458 6 GALSULFASE INJECTION 0.00
J1459 6 INJ IVIG PRIVIGEN 500 MG 0.00
J1460 5 GAMMA GLOBULIN 1 CC INJ 0.00
J1470 5 GAMMA GLOBULIN 2 CC INJ 0.00
J1480 5 GAMMA GLOBULIN 3 CC INJ 0.00
J1490 5 GAMMA GLOBULIN 4 CC INJ 0.00
J1500 5 GAMMA GLOBULIN 5 CC INJ 0.00
J1510 5 GAMMA GLOBULIN 6 CC INJ 0.00
J1520 5 GAMMA GLOBULIN 7 CC INJ 0.00
J1530 5 GAMMA GLOBULIN 8 CC INJ 0.00
J1540 5 GAMMA GLOBULIN 9 CC INJ 0.00
J1550 5 GAMMA GLOBULIN 10 CC INJ 0.00
J1560 5 GAMMA GLOBULIN > 10 CC INJ 0.00
J1561 6 IMMUNE GLOBULIN 500 MG 0.00
J1562 6 VIVAGLOBIN, INJ 0.00
J1563 O IV IMMUNE GLOBULIN 0.00
J1564 O IMMUNE GLOBULIN 10 MG 0.00
J1565 5 RSV-IVIG 0.00
J1566 5 IMMUNE GLOBULIN, POWDER 0.00
J1567 O IMMUNE GLOBULIN, LIQUID 0.00
J1568 6 OCTAGAM INJECTION 0.00
J1569 6 GAMMAGARD LIQUID INJECTION 0.00
J1570 6 GANCICLOVIR SODIUM INJECTION 0.00
J1571 6 HEPAGAM B IM INJECTION 0.00
J1572 6 FLEBOGAMMA INJECTION 0.00
J1573 6 HEPAGAM B INTRAVENOUS, INJ 0.00
J1580 6 GARAMYCIN GENTAMICIN INJ 0.00
J1590 5 GATIFLOXACIN INJECTION 0.00
J1595 6 INJECTION GLATIRAMER ACETATE 0.00
J1600 5 GOLD SODIUM THIOMALEATE INJ 0.00
J1610 5 GLUCAGON HYDROCHLORIDE/1 MG 0.00
J1620 5 GONADORELIN HYDROCH/ 100 MCG 0.00
J1625 O INJECTION, GRANISETRON HYDROCHLORID 0.00
J1626 6 GRANISETRON HCL INJECTION 0.00
J1630 5 HALOPERIDOL INJECTION 0.00
J1631 5 HALOPERIDOL DECANOATE INJ 0.00
J1640 5 INJECTION, HEMIN, 1 MG 0.00
J1642 6 INJ HEPARIN SODIUM PER 10 U 0.00
J1644 6 INJ HEPARIN SODIUM PER 1000U 0.00
J1645 5 DALTEPARIN SODIUM 0.00
J1650 6 INJ ENOXAPARIN SODIUM 0.00
J1652 5 FONDAPARINUX SODIUM 0.00
J1655 6 TINZAPARIN SODIUM INJECTION 0.00
J1660 O INJECTION, HISTAMINE, UP TO 2.75 MG 0.00
J1670 5 TETANUS IMMUNE GLOBULIN INJ 0.00
J1675 5 HISTRELIN ACETATE 0.00