Description - DE Medical Assistance Program

40527 RECONSTRUCT LIP WITH FLAP 3 $607.23
4052F HEMODIALYSIS VIA AV FISTULA 9 $0.00
40530 PARTIAL REMOVAL OF LIP 3 $503.83
4053F HEMODIALYSIS VIA AV GRAFT 9 $0.00
4054F HEMODIALYSIS VIA CATHETER 9 $0.00
4055F PT RCVNG PERITON DIALYSIS 9 $0.00
4056F APPROP ORAL REHYD RECOMMD 9 $0.00
4058F PED GASTRO ED GIVEN, CAREGVR 9 $0.00
4060F PSYCH SVCS PROVIDED 9 $0.00
4062F PT REFERRAL PSYCH DOCD 9 $0.00
4063F ANTIDEPRES RXTHXPY NOT RXD 9 $0.00
4064F ANTIDEPRESSANT RX 9 $0.00
40650 REPAIR LIP 3 $381.85
40652 REPAIR LIP 3 $447.68
40654 REPAIR LIP 3 $526.18
4065F ANTIPSYCHOTIC RX 9 $0.00
4066F ECT PROVIDED 9 $0.00
4067F PT REFERRAL FOR ECT DOCD 9 $0.00
40700 REPAIR CLEFT LIP/NASAL 3 $877.05
40701 REPAIR CLEFT LIP/NASAL 3 $1,066.38
40702 REPAIR CLEFT LIP/NASAL 3 $811.01
4070F DVT PROPHYLX RECVD DAY 2 9 $0.00
40720 REPAIR CLEFT LIP/NASAL 3 $942.52
4073F ORAL ANTIPLAT THX RX DISCHRG 9 $0.00
4075F ANTICOAG THX RX AT DISCHRG 9 $0.00
40761 REPAIR CLEFT LIP/NASAL 3 $1,012.65
4077F DOC T-PA ADMIN CONSIDERED 9 $0.00
40799 LIP SURGERY PROCEDURE 5 $0.00
4079F DOC REHAB SVCS CONSIDERED 9 $0.00
40800 DRAINAGE OF MOUTH LESION 3 $186.14
40801 DRAINAGE OF MOUTH LESION 3 $283.55
40804 REMOVAL, FOREIGN BODY, MOUTH 3 $191.36
40805 REMOVAL, FOREIGN BODY, MOUTH 3 $293.84
40806 INCISION OF LIP FOLD 3 $95.76
40808 BIOPSY OF MOUTH LESION 3 $166.96
40810 EXCISION OF MOUTH LESION 3 $185.24
40812 EXCISE/REPAIR MOUTH LESION 3 $258.88
40814 EXCISE/REPAIR MOUTH LESION 3 $348.35
40816 EXCISION OF MOUTH LESION 3 $367.63
40818 EXCISE ORAL MUCOSA FOR GRAFT 3 $325.84
40819 EXCISE LIP OR CHEEK FOLD 3 $277.81
40820 TREATMENT OF MOUTH LESION 3 $241.11
40830 REPAIR MOUTH LACERATION 3 $225.16
40831 REPAIR MOUTH LACERATION 3 $296.79
40840 RECONSTRUCTION OF MOUTH 3 $739.60
40842 RECONSTRUCTION OF MOUTH 3 $746.62
40843 RECONSTRUCTION OF MOUTH 3 $964.58
40844 RECONSTRUCTION OF MOUTH 3 $1,272.60
40845 RECONSTRUCTION OF MOUTH 3 $1,373.66