Description - DE Medical Assistance Program

78608 26 3 55.17
78609 26 3 55.17
88361 26 3 55.2
88305 TC 3 55.3
79005 TC 3 55.35
93024 TC 3 55.71
88358 26 3 55.97
E0615 RR 3 55.97
75827 26 3 56.01
E0948 RR 3 56.1
74210 TC 3 56.46
76815 TC 3 56.46
76930 TC 3 56.46
72285 26 3 56.48
93892 26 3 56.49
70460 26 3 56.52
51792 26 3 56.54
E0946 RR 3 56.6
E0974 UE 3 56.69
70373 TC 3 56.82
74740 TC 3 56.82
76377 TC 3 56.82
76604 TC 3 56.82
93893 26 3 56.86
70486 26 3 56.87
E0200 UE 3 56.9
E0135 UE 3 56.91
75825 26 3 56.99
K0047 UE 3 57.06
91000 TC 3 57.19
75710 26 3 57.24
76813 26 3 57.32
88112 TC 3 57.41
75746 26 3 57.49
75870 26 3 57.49