10.12.2012 Views

Description - DE Medical Assistance Program

Description - DE Medical Assistance Program

Description - DE Medical Assistance Program

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

34101 REMOVAL OF ARTERY CLOT 3 $613.10<br />

34111 REMOVAL OF ARM ARTERY CLOT 3 $612.99<br />

34151 REMOVAL OF ARTERY CLOT 3 $1,413.45<br />

34201 REMOVAL OF ARTERY CLOT 3 $1,031.14<br />

34203 REMOVAL OF LEG ARTERY CLOT 3 $978.96<br />

34401 REMOVAL OF VEIN CLOT 3 $1,455.28<br />

34421 REMOVAL OF VEIN CLOT 3 $744.69<br />

34451 REMOVAL OF VEIN CLOT 3 $1,513.15<br />

34471 REMOVAL OF VEIN CLOT 3 $1,128.72<br />

34490 REMOVAL OF VEIN CLOT 3 $616.11<br />

34501 REPAIR VALVE, FEMORAL VEIN 3 $943.52<br />

34502 RECONSTRUCT VENA CAVA 3 $1,532.51<br />

3450F DYSPNEA SCRND, NO-MILD DYSP 9 $0.00<br />

34510 TRANSPOSITION OF VEIN VALVE 3 $1,099.15<br />

3451F DYSPNEA SCRND MOD-HIGH DYSP 9 $0.00<br />

34520 CROSS-OVER VEIN GRAFT 3 $1,039.37<br />

3452F DYSPNEA NOT SCREENED 9 $0.00<br />

34530 LEG VEIN FUSION 3 $1,007.87<br />

3455F TB SCRNG DONE-INTERPD 6MON 9 $0.00<br />

3470F RA DISEASE ACTIVITY, LOW 9 $0.00<br />

3471F RA DISEASE ACTIVITY, MOD 9 $0.00<br />

3472F RA DISEASE ACTIVITY, HIGH 9 $0.00<br />

3475F DISEASE PROGN RA POOR DOCD 9 $0.00<br />

3476F DISEASE PROGN RA GOOD DOCD 9 $0.00<br />

34800 ENDOVAS AAA REPR W/SM TUBE 3 $1,156.38<br />

34802 ENDOVAS AAA REPR W/2-P PART 3 $1,274.77<br />

34803 ENDOVAS AAA REPR W/3-P PART 3 $1,315.90<br />

34804 ENDOVAS AAA REPR W/1-P PART 3 $1,276.10<br />

34805 ENDOVAS AAA REPR W/LONG TUBE 3 $1,206.41<br />

34806 ANEURYSM PRESS SENSOR ADD-ON 3 $105.22<br />

34808 ENDOVAS ILIAC A <strong>DE</strong>VICE ADDON 3 $207.85<br />

34812 XPOSE FOR ENDOPROSTH, FEMORL 3 $341.49<br />

34813 FEMORAL ENDOVAS GRAFT ADD-ON 3 $241.32<br />

34820 XPOSE FOR ENDOPROSTH, ILIAC 3 $493.04<br />

34825 ENDOVASC EXTEND PROSTH, INIT 3 $714.94<br />

34826 ENDOVASC EXTEN PROSTH, ADDL 3 $209.83<br />

34830 OPEN AORTIC TUBE PROSTH REPR 3 $1,846.28<br />

34831 OPEN AORTOILIAC PROSTH REPR 3 $1,962.98<br />

34832 OPEN AORTOFEMOR PROSTH REPR 3 $1,984.80<br />

34833 XPOSE FOR ENDOPROSTH, ILIAC 3 $619.04<br />

34834 XPOSE, ENDOPROSTH, BRACHIAL 3 $280.38<br />

34900 ENDOVASC ILIAC REPR W/GRAFT 3 $918.71<br />

3490F HISTORY - AIDS-<strong>DE</strong>FINING COND 9 $0.00<br />

3491F HIV UNSURE BABY OF HIV+MOMS 9 $0.00<br />

3492F HISTORY CD4+ CELL COUNT

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!