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Division of Medical Assistance |
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NC Health Choice - Immunizations
Report Period: October 1, 1998 through September 30, 1999
| Health Service Code | Description | Number of Encounters | Amount Paid |
|---|---|---|---|
| G0010 | ADMINISTRATION OF HEPATITIS B VACCINE | 3 | $15.00 |
| 90645 | HIB VACCINE, HBOC CONJUGATE | 82 | $1,023.74 |
| 90646 | HIB VACCINE; PRP-D CONJUGATE | 5 | $48.56 |
| 90647 | HIB VACCINE; PRP-OMP CONJUGAT | 179 | $2,054.11 |
| 90648 | HIB VACCINE; PRP-T CONJUGATE | 6 | $57.70 |
| 90700 | DTAP IMMUNIZATION | 1109 | $13,161.26 |
| 90701 | DTP IMMUNIZATION | 110 | $1,529.58 |
| 90702 | DT IMMUNIZATION | 107 | $1,523.77 |
| 90703 | TETANUS IMMUNIZATION | 69 | $970.94 |
| 90704 | MUMPS IMMUNIZATION | 1 | 5.49 |
| 90705 | MEASLES IMMUNIZATION | 1 | $13.71 |
| 90707 | MMR VIRUS IMMUNIZATION | 1044 | $12,718.26 |
| 90708 | MEASLES-RUBELLA IMMUNIZATION | 1 | $6.86 |
| 90710 | MMRV - COMBINED VACCINE | 3 | $41.13 |
| 90711 | COMBINED VACCINE | 5 | $28.71 |
| 90712 | ORAL POLIOVIRUS IMMUNIZATION | 748 | $7,815.22 |
| 90713 | POLIOMYELITIS IMMUNIZATION | 82 | $1,052.40 |
| 90716 | CHICKEN POX VACCINE | 495 | $7,847.38 |
| 90720 | DTP/HIB VACCINE | 17 | $390.42 |
| 90721 | DPAT AND HIB VACCINE | 3 | $88.00 |
| 90737 | INFLUENZA B IMMUNIZATION | 329 | $3,780.54 |
| 90744 | HEPATITIS B VAC PED/ADOLESCENT | 542 | $7,894.86 |
| 90745 | HEPATITIS B VAC ADOL/HIGH RISK | 225 | $3,625.60 |
| 90748 | HEPATITIS B AND HIB VACCINE | 18 | $252.55 |
| Total | 5184 | $65,945.79 |
Note: NORTH CAROLINA IS A UNIVERSAL VACCINE STATE, AFFORDING VACCINES FOR ALL THE STATE'S CHILDREN. THESE FIGURES REPRESENT ADMINISTRATIVE FEES PHYSICIANS BILL FOR ADMINISTERING THE IMMUNIZATION.