fee schedule 2009 new - DE Medical Assistance Program

K0041 3 LARGE SIZE FOOTPLATE EACH 52.65
K0042 3 STANDARD SIZE FOOTPLATE EACH 36.25
K0043 3 FTRST LOWER EXTENSION TUBE 19.44
K0044 3 FTRST UPPER HANGER BRACKET 16.56
K0045 3 FOOTREST COMPLETE ASSEMBLY 56.34
K0046 3 ELEVAT LEGRST LOW EXTENSION 19.44
K0047 3 ELEVAT LEGRST UP HANGR BRACK 76.10
K0048 O ELEVATE LEGREST COMPLETE 0.00
K0049 O CALF PAD EACH 0.00
K0050 3 RATCHET ASSEMBLY 32.34
K0051 3 CAM RELESE ASSEM FTRST/LGRST 52.35
K0052 3 SWINGAWAY DETACH FOOTREST 91.98
K0053 3 ELEVATE FOOTREST ARTICULATE 101.51
K0054 O SEAT WDTH 10-12/15/17/20 WC 0.00
K0055 O SEAT DPTH 15/17/18 LTWT WC 0.00
K0056 3 SEAT HT =21 LTWT WC 94.63
K0057 O SEAT WDTH 19/20 HVY DTY WC 0.00
K0058 O SEAT DPTH 17/18 POWER WC 0.00
K0059 O PLASTIC COATED HANDRIM EACH 0.00
K0060 O STEEL HANDRIM EACH 0.00
K0061 O ALUMINUM HANDRIM EACH 0.00
K0062 O HANDRIM 8-10 VERT/OBLIQ PROJ 0.00
K0063 O HNDRM 12-16 VERT/OBLIQ PROJ 0.00
K0064 O ZERO PRESSURE TUBE FLAT FREE 0.00
K0065 3 SPOKE PROTECTORS 44.24
K0066 O SOLID TIRE ANY SIZE EACH 0.00
K0067 O PNEUMATIC TIRE ANY SIZE EACH 0.00
K0068 O PNEUMATIC TIRE TUBE EACH 0.00
K0069 3 REAR WHL COMPLETE SOLID TIRE 99.42
K0070 3 REAR WHL COMPL PNEUM TIRE 182.26
K0071 3 FRONT CASTR COMPL PNEUM TIRE 108.71
K0072 3 FRNT CSTR CMPL SEM-PNEUM TIR 65.43
K0073 3 CASTER PIN LOCK EACH 34.63
K0074 O PNEUMATIC CASTER TIRE EACH 0.00
K0075 O SEMI-PNEUMATIC CASTER TIRE 0.00
K0076 O SOLID CASTER TIRE EACH 0.00
K0077 3 FRONT CASTER ASSEM COMPLETE 58.56
K0078 O PNEUMATIC CASTER TIRE TUBE 0.00
K0079 O WHEEL LOCK EXTENSION PAIR 0.00
K0080 O ANTI-ROLLBACK DEVICE PAIR 0.00
K0081 O WHEEL LOCK ASSEMBLY COMPLETE 0.00
K0082 O 22 NF NONSEALED LEADACID 0.00
K0083 O 22NF SEALED LEADACID BATTERY 0.00
K0084 O GR24 NONSEALED LEADACID 0.00
K0085 O GR 24 SEALED LEAD ACID BATTERY 0.00
K0086 O U1NONSEALED LEADACID BATTERY 0.00
K0087 O U1 SEALED LEADACID BATTERY 0.00
K0088 O BATTERY CHARGER, SINGLE MODE 0.00
K0089 O BATTERY CHARGER, DUAL MODE 0.00
K0090 O REAR TIRE POWER WHEELCHAIR 0.00