PHYSICIAN ADMINISTERED DRUG FEE SCHEDULE Effective …
influenza virus vaccine, quadrivalent, split virus, preservative free, for intradermal use 19 999: 10/01/2013 12/31/9999: 1 18.92: 90655 fee on file
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www.medicaid.ms.govBegin Date; End Date Modifier-Status: Base Units/Fee 00100: 10/01/2003 12/31/9999: Base Units 5: 00102 10/01/2003: 12/31/9999 Base Units: 6 00103: 10/01/2003 12/31/9999
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