Description - DE Medical Assistance Program

Q9924 EPOETIN WITH HCT = 24 O $0.00
Q9925 EPOETIN WITH HCT = 25 O $0.00
Q9926 EPOETIN WITH HCT = 26 O $0.00
Q9927 EPOETIN WITH HCT = 27 O $0.00
Q9928 EPOETIN WITH HCT = 28 O $0.00
Q9929 EPOETIN WITH HCT = 29 O $0.00
Q9930 EPOETIN WITH HCT = 30 O $0.00
Q9931 EPOETIN WITH HCT = 31 O $0.00
Q9932 EPOETIN WITH HCT = 32 O $0.00
Q9933 EPOETIN WITH HCT = 33 O $0.00
Q9934 EPOETIN WITH HCT = 34 O $0.00
Q9935 EPOETIN WITH HCT = 35 O $0.00
Q9936 EPOETIN WITH HCT = 36 O $0.00
Q9937 EPOETIN WITH HCT = 37 O $0.00
Q9938 EPOETIN WITH HCT = 38 O $0.00
Q9939 EPOETIN WITH HCT = 39 O $0.00
Q9940 EPOETIN WITH HCT >= 40 O $0.00
Q9945 LOCM = 400 MG/ML IODINE,1ML 9 $0.00
Q9952 INJ GAD-BASE MR CONTRAST,1ML O $0.00
Q9953 INJ FE-BASED MR CONTRAST,1ML 9 $0.00
Q9954 ORAL MR CONTRAST, 100 ML 9 $0.00
Q9955 INJ PERFLEXANE LIP MICROS,ML 6 $0.00
Q9956 INJ OCTAFLUOROPROPANE MIC,ML 3 $48.01
Q9957 INJ PERFLUTREN LIP MICROS,ML 6 $0.00
Q9958 HOCM = 400MG/ML IODINE, 1ML 9 $0.00
Q9965 LOCM 100-199MG/ML IODINE,1ML 9 $0.00
Q9966 LOCM 200-299MG/ML IODINE,1ML 9 $0.00
Q9967 LOCM 300-399MG/ML IODINE,1ML 9 $0.00
Q9968 VISUALIZATION ADJUNCT 9 $0.00
R0059 NOT OTHERWISE CLASSIFIED, CHEST 9 $0.00
R0065 CIRCULATION TIME, RADIONUCLIDE STUD 9 $0.00
R0070 TRANSPORT PORTABLE X-RAY 9 $0.00
R0075 TRANSPORT PORT X-RAY MULTIPL 9 $0.00
R0076 TRANSPORT PORTABLE EKG 9 $0.00
R0085 MULTIPLE RADIOLOGY SERVICES 9 $0.00
S0009 INJECTION, BUTORPHANOL TARTR O $0.00
S0010 INJECTION, SOMATREM, 5 MG O $0.00