Description - DE Medical Assistance Program

96413 CHEMO, IV INFUSION, 1 HR 3 $142.63
96414 CHEMO, INFUSE METHOD ADD-ON O $0.00
96415 CHEMO, IV INFUSION, ADDL HR 3 $30.70
96416 CHEMO PROLONG INFUSE W/PUMP 3 $156.27
96417 CHEMO IV INFUS EACH ADDL SEQ 3 $70.49
96420 CHEMO, IA, PUSH TECNIQUE 3 $105.15
96422 CHEMO IA INFUSION UP TO 1 HR 3 $169.50
96423 CHEMO IA INFUSE EACH ADDL HR 3 $76.69
96425 CHEMOTHERAPY,INFUSION METHOD 3 $170.12
96440 CHEMOTHERAPY, INTRACAVITARY 3 $660.53
96445 CHEMOTHERAPY, INTRACAVITARY 3 $279.73
96450 CHEMOTHERAPY, INTO CNS 3 $200.11
96520 PORT PUMP REFILL & MAIN O $0.00
96521 REFILL/MAINT, PORTABLE PUMP 3 $125.70
96522 REFILL/MAINT PUMP/RESVR SYST 3 $106.48
96523 IRRIG DRUG DELIVERY DEVICE 3 $24.60
96530 SYST PUMP REFILL & MAIN O $0.00
96542 CHEMOTHERAPY INJECTION 3 $127.75
96545 PROVIDE CHEMOTHERAPY AGENT O $0.00
96549 CHEMOTHERAPY, UNSPECIFIED 5 $0.00
96567 PHOTODYNAMIC TX, SKIN 3 $120.07
96570 PHOTODYNMC TX, 30 MIN ADD-ON 3 $57.23
96571 PHOTODYNAMIC TX, ADDL 15 MIN 3 $27.04
96900 ULTRAVIOLET LIGHT THERAPY 3 $19.47
96902 TRICHOGRAM 3 $21.05
96904 WHOLE BODY PHOTOGRAPHY 9 $0.00
96910 PHOTOCHEMOTHERAPY WITH UV-B 3 $63.48
96912 PHOTOCHEMOTHERAPY WITH UV-A 3 $81.60
96913 PHOTOCHEMOTHERAPY, UV-A OR B 3 $112.67
96920 LASER TX, SKIN < 250 SQ CM 3 $163.50
96921 LASER TX, SKIN 250-500 SQ CM 3 $162.00
96922 LASER TX, SKIN > 500 SQ CM 3 $237.01
96999 DERMATOLOGICAL PROCEDURE 5 $0.00
97001 PT EVALUATION 3 $70.48
97002 PT RE-EVALUATION 3 $38.20
97003 OT EVALUATION 3 $75.66
97004 OT RE-EVALUATION 3 $44.85
97005 ATHLETIC TRAIN EVAL 9 $0.00
97006 ATHLETIC TRAIN REEVAL 9 $0.00
97010 HOT OR COLD PACKS THERAPY 3 $4.97
97012 MECHANICAL TRACTION THERAPY 3 $14.72
97014 ELECTRIC STIMULATION THERAPY 3 $13.70
97016 VASOPNEUMATIC DEVICE THERAPY 3 $15.92
97018 PARAFFIN BATH THERAPY 3 $8.30
97020 MICROWAVE THERAPY O $0.00
97022 WHIRLPOOL THERAPY 3 $18.52
97024 DIATHERMY EG, MICROWAVE 3 $5.71
97026 INFRARED THERAPY 3 $4.97
97028 ULTRAVIOLET THERAPY 3 $6.43