fee schedule 2009 new - DE Medical Assistance Program

L0120 3 CERV FLEXIBLE NON-ADJUSTABLE 20.07
L0130 3 FLEX THERMOPLASTIC COLLAR MO 141.92
L0140 3 CERVICAL SEMI-RIGID ADJUSTAB 46.91
L0150 3 CERV SEMI-RIG ADJ MOLDED CHN 86.11
L0160 3 CERV SEMI-RIG WIRE OCC/MAND 112.45
L0170 3 CERVICAL COLLAR MOLDED TO PT 463.04
L0172 3 CERV COL THERMPLAS FOAM 2 PI 100.39
L0174 3 CERV COL FOAM 2 PIECE W THOR 197.24
L0180 3 CER POST COL OCC/MAN SUP ADJ 273.50
L0190 3 CERV COLLAR SUPP ADJ CERV BA 355.67
L0200 3 CERV COL SUPP ADJ BAR & THOR 370.78
L0210 3 THORACIC RIB BELT 34.05
L0220 3 THOR RIB BELT CUSTOM FABRICA 101.25
L0300 O TLSO FLEX SURGICAL SUPPORT 0.00
L0310 O TLSO FLEXIBLE CUSTOM FABRICA 0.00
L0315 O TLSO FLEX ELAS RIGID POST PA 0.00
L0317 O TLSO FLEX HYPEXT ELAS POST P 0.00
L0320 O TLSO A-P CONTRL W APRON FRNT 0.00
L0321 O TLSO ANTI-POST-CNTRL PREFAB 0.00
L0330 O TLSO ANT-POS-LATERAL CONTROL 0.00
L0331 O TLSO ANT-POST-LAT CNTRL PRFB 0.00
L0340 O TLSO A-P-L-ROTARY WITH APRON 0.00
L0350 O TLSO FLEX COMPRESS JACKET CU 0.00
L0360 O TLSO FLEX COMPRESS JACKET MO 0.00
L0370 O TLSO A-P-L-ROTARY HYPEREXTEN 0.00
L0380 O TLSO A-P-L-ROT W/ POS EXTENS 0.00
L0390 O TLSO A-P-L CONTROL MOLDED 0.00
L0391 O TLSO ANT-POST-LAT-ROT CNTRL 0.00
L0400 O TLSO A-P-L W INTERFACE MATER 0.00
L0410 O TLSO A-P-L TWO PIECE CONSTR 0.00
L0420 O TLSO A-P-L 2 PIECE W INTERFA 0.00
L0430 6 TLSO A-P-L W INTERFACE CUSTM 0.00
L0440 O TLSO A-P-L OVERLAP FRNT CUST 0.00
L0450 5 TLSO FLEX PREFAB THORACIC 0.00
L0452 5 TLSO FLEX CUSTOM FAB THORACI 0.00
L0454 5 TLSO FLEX PREFAB SACROCOC-T9 0.00
L0456 5 TLSO FLEX PREFAB 0.00
L0458 5 TLSO 2MOD SYMPHIS-XIPHO PRE 0.00
L0460 5 TLSO2MOD SYMPHYSIS-STERN PRE 0.00
L0462 3 TLSO 3MOD SACRO-SCAP PRE 1,050.90
L0464 5 TLSO 4MOD SACRO-SCAP PRE 0.00
L0466 5 TLSO RIGID FRAME PRE SOFT AP 0.00
L0468 5 TLSO RIGID FRAME PREFAB PELV 0.00
L0470 5 TLSO RIGID FRAME PRE SUBCLAV 0.00
L0472 5 TLSO RIGID FRAME HYPEREX PRE 0.00
L0474 5 TLSO RIGID FRAME PRE PELVIC 0.00
L0476 O TLSO FLEXION COMPRES JAC PRE 0.00
L0478 O TLSO FLEXION COMPRES JAC CUS 0.00
L0480 5 TLSO RIGID PLASTIC CUSTOM FA 0.00
L0482 5 TLSO RIGID LINED CUSTOM FAB 0.00