fee schedule 2009 new - DE Medical Assistance Program

J3315 5 TRIPTORELIN PAMOATE 0.00
J3320 5 SPECTINOMYCN DI-HCL INJ 0.00
J3340 O INJECTION, CRYPTENAMINE ACETATE, UP 0.00
J3350 5 UREA INJECTION 0.00
J3355 9 UROFOLLITROPIN, 75 IU 0.00
J3360 5 DIAZEPAM INJECTION 0.00
J3364 5 UROKINASE 5000 IU INJECTION 0.00
J3365 5 UROKINASE 250,000 IU INJ 0.00
J3370 6 VANCOMYCIN HCL INJECITON 0.00
J3380 O INJECTION, ISOXSUPRINE HCL, UP TO 1 0.00
J3390 O METHOXAMINE INJECTION 0.00
J3395 O VERTEPORFIN INJECTION 0.00
J3396 6 VERTEPORFIN INJECTION 0.00
J3400 5 TRIFLUPROMAZINE HCL INJ 0.00
J3410 6 HYDROXYZINE HCL INJECITON 0.00
J3411 6 THIAMINE HCL 100 MG 0.00
J3415 6 PYRIDOXINE HCL 100 MG 0.00
J3420 6 VITAMIN B12 INJECTION 0.00
J3430 5 VITAMIN K PHYTONADIONE INJ 0.00
J3450 O MEPHENTERMINE SULFATE INJ 0.00
J3465 6 INJECTION, VORICONAZOLE 0.00
J3470 5 HYALURONIDASE INJECTION 0.00
J3471 5 OVINE, UP TO 999 USP UNITS 0.00
J3472 5 OVINE, 1000 USP UNITS 0.00
J3473 6 HYALURONIDASE RECOMBINANT 0.00
J3475 6 INJ MAGNESIUM SULFATE 0.00
J3480 6 INJ POTASSIUM CHLORIDE 0.00
J3485 5 ZIDOVUDINE 0.00
J3486 6 ZIPRASIDONE MESYLATE 0.00
J3487 6 ZOLEDRONIC ACID 0.00
J3488 6 RECLAST INJECTION 0.00
J3490 5 DRUGS UNCLASSIFIED INJECTION 0.00
J3500 O VITAMIN THERAPY 0.00
J3520 5 EDETATE DISODIUM PER 150 MG 0.00
J3530 9 NASAL VACCINE INHALATION 0.00
J3535 9 METERED DOSE INHALER DRUG 0.00
J3540 O AUTOGENOUS BLOOD EXTRACT, INTRAVENO 0.00
J3550 O INTRA-ARTERIAL OXYGEN INJECTION 0.00
J3560 O ADRENAL CORTEX EXTRACT 0.00
J3570 9 LAETRILE AMYGDALIN VIT B17 0.00
J3590 5 UNCLASSIFIED BIOLOGICS 0.00
J6015 O TYPHUS 0.00
J7010 O VIAL OF ALLERGY VACCINE, SINGLE DOS 0.00
J7020 O VIAL OF ALLERGY VACCINE, MULTIPLE D 0.00
J7030 6 NORMAL SALINE SOLUTION INFUS 0.00
J7040 6 NORMAL SALINE SOLUTION INFUS 0.00
J7042 6 5% DEXTROSE/NORMAL SALINE 0.00
J7050 6 NORMAL SALINE SOLUTION INFUS 0.00
J7051 O STERILE SALINE/WATER 0.00
J7060 5 5% DEXTROSE/WATER 0.00