fee schedule 2009 new - DE Medical Assistance Program

L3570 5 O SHOE ADD INSTEP EXTENSION 0.00
L3580 5 O SHOE ADD INSTEP VELCRO CLO 0.00
L3590 5 O SHOE CONVERT TO SOF COUNTE 0.00
L3595 5 ORTHO SHOE ADD MARCH BAR 0.00
L3600 5 TRANS SHOE CALIP PLATE EXIST 0.00
L3610 3 TRANS SHOE CALIPER PLATE NEW 30.00
L3620 5 TRANS SHOE SOLID STIRRUP EXI 0.00
L3630 5 TRANS SHOE SOLID STIRRUP NEW 0.00
L3640 5 SHOE DENNIS BROWNE SPLINT BO 0.00
L3649 5 ORTHOPEDIC SHOE MODIFICA NOS 0.00
L3650 3 SHLDER FIG 8 ABDUCT RESTRAIN 47.75
L3651 5 PREFAB SHOULDER ORTHOSIS 0.00
L3652 5 PREFAB DBL SHOULDER ORTHOSIS 0.00
L3660 3 ABDUCT RESTRAINER CANVAS&WEB 72.21
L3670 3 ACROMIO/CLAVICULAR CANVAS&WE 95.42
L3671 6 SO CAP DESIGN W/O JNTS CF 0.00
L3672 6 SO AIRPLANE W/O JNTS CF 0.00
L3673 6 SO AIRPLANE W/JOINT CF 0.00
L3675 3 CANVAS VEST SO 119.70
L3677 5 SO HARD PLASTIC STABILIZER 0.00
L3700 3 ELBOW ORTHOSES ELAS W STAYS 49.04
L3701 3 PREFAB ELBOW ORTHOSIS 14.56
L3702 6 EO W/O JOINTS CF 0.00
L3710 3 ELBOW ELASTIC WITH METAL JOI 109.80
L3720 3 FOREARM/ARM CUFFS FREE MOTIO 489.89
L3730 3 FOREARM/ARM CUFFS EXT/FLEX A 633.36
L3740 3 CUFFS ADJ LOCK W/ ACTIVE CON 750.90
L3760 3 EO WITHJOINT, PREFABRICATED 341.11
L3762 5 RIGID EO WO JOINTS 0.00
L3763 6 EWHO RIGID W/O JNTS CF 0.00
L3764 6 EWHO W/JOINT(S) CF 0.00
L3765 6 EWHFO RIGID W/O JNTS CF 0.00
L3766 6 EWHFO W/JOINT(S) CF 0.00
L3800 O WHFO SHORT OPPONEN NO ATTACH 0.00
L3805 O WHFO LONG OPPONENS NO ATTACH 0.00
L3806 6 WHFO W/JOINT(S) CUSTOM FAB 0.00
L3807 3 WHFO,NO JOINT, PREFABRICATED 170.55
L3808 6 WHFO, RIGID W/O JOINTS 0.00
L3810 O WHFO THUMB ABDUCTION BAR 0.00
L3815 O WHFO SECOND M.P. ABDUCTION A 0.00
L3820 O WHFO IP EXT ASST W/ MP EXT S 0.00
L3825 O WHFO M.P. EXTENSION STOP 0.00
L3830 O WHFO M.P. EXTENSION ASSIST 0.00
L3835 O WHFO M.P. SPRING EXTENSION A 0.00
L3840 O WHFO SPRING SWIVEL THUMB 0.00
L3845 O WHFO THUMB IP EXT ASS W/ MP 0.00
L3850 O ACTION WRIST W/ DORSIFLEX AS 0.00
L3855 O WHFO ADJ M.P. FLEXION CONTRO 0.00
L3860 O WHFO ADJ M.P. FLEX CTRL & I. 0.00
L3890 O TORSION MECHANISM WRIST/ELBO 0.00