fee schedule 2009 new - DE Medical Assistance Program

Q4048 9 CAST SUP SHT LEG SPLNT PED F 0.00
Q4049 9 FINGER SPLINT, STATIC 0.00
Q4050 9 CAST SUPPLIES UNLISTED 0.00
Q4051 9 SPLINT SUPPLIES MISC 0.00
Q4054 O DARBEPOETIN ALFA, ESRD USE 0.00
Q4055 O EPOETIN ALFA, ESRD USE 0.00
Q4075 O ACYCLOVIR, 5 MG 0.00
Q4076 O DOPAMINE HCL, 40 MG 0.00
Q4077 O TREPROSTINIL, 1 MG 0.00
Q4079 O NATALIZUMAB INJECTION 0.00
Q4080 9 ILOPROST NON-COMP UNIT DOSE 0.00
Q4081 6 EPOETIN ALFA, 100 UNITS ESRD 0.00
Q4082 9 DRUG/BIO NOC PART B DRUG CAP 0.00
Q4083 O HYALURONAN OR DERIVATIVE, HYALGAN 0.00
Q4084 O HYALURONAN OR DERIVATIVE, SYNVISC, 0.00
Q4085 6 HYALURONAN OR DERIVATIVE, EUFLEXXA 0.00
Q4086 O HYALURONAN OR DERIVATIVE, ORTHVISC 0.00
Q4096 O INJECTION, VON WILLEBRAND FACTOR C 0.00
Q4097 O INJECTION, IMMUNE GLOBULIN (PRIVIG 0.00
Q4098 O INJECTION, IRON DEXTRAN, 50 MG 0.00
Q4099 O FORMOTEROL FUMARATE INHALATION UD 0.00
Q4100 9 SKIN SUBSTITUTE, NOS 0.00
Q4101 9 APLIGRAF SKIN SUB 0.00
Q4102 9 OASIS WOUND MATRIX SKIN SUB 0.00
Q4103 9 OASIS BURN MATRIX SKIN SUB 0.00
Q4104 9 INTEGRA BMWD SKIN SUB 0.00
Q4105 9 INTEGRA DRT SKIN SUB 0.00
Q4106 9 DERMAGRAFT SKIN SUB 0.00
Q4107 9 GRAFTJACKET SKIN SUB 0.00
Q4108 9 INTEGRA MATRIX SKIN SUB 0.00
Q4109 9 TISSUEMEND SKIN SUB 0.00
Q4110 9 PRIMATRIX SKIN SUB 0.00
Q4111 9 GAMMAGRAFT SKIN SUB 0.00
Q4112 9 CYMETRA ALLOGRAFT 0.00
Q4113 9 GRAFTJACKET EXPRESS ALLOGRAF 0.00
Q4114 9 INTEGRA FLOWABLE WOUND MATRI 0.00
Q5001 9 HOSPICE IN PATIENT HOME 0.00
Q5002 9 HOSPICE IN ASSISTED LIVING 0.00
Q5003 9 HOSPICE IN LT/NON-SKILLED NF 0.00
Q5004 9 HOSPICE IN SNF 0.00
Q5005 9 HOSPICE, INPATIENT HOSPITAL 0.00
Q5006 9 HOSPICE IN HOSPICE FACILITY 0.00
Q5007 9 HOSPICE IN LTCH 0.00
Q5008 9 HOSPICE IN INPATIENT PSYCH 0.00
Q5009 9 HOSPICE CARE, NOS 0.00
Q9920 O EPOETIN WITH HCT