medicare administration code for shingles vaccine

The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. The Part D plan is not required to pay if in full, although the patient may receive a negotiated rate. Bulletin, and related materials internally within your organization within the United States for The AMA does not directly or CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Recommendations for adult immunizations Preventing disease and detecting health issues at an early stage helps you live a healthy life. There are two shingles vaccines available for healthy older adults. All rights reserved. 5. The AMA is a third-party beneficiary to this license. Keep in mind that all Medicare Part B enrollees have coverage for pneumococcal and influenza vaccines, while hepatitis B vaccine is covered only for specific high-risk patients. Vaccine Administration Guidelines and Claim Payment Policy. BILLING GUIDANCE FOR VACCINE ADMINISTRATIVE CODES All of the units billed for CPT codes 90471EP/TJ, 90472EP/TJ, 90473EP/TJ and 90474EP/TJ must be billed on ONE detail to avoid duplicate audit denials. In regards to inventory reporting, DTaP (CVX-20) is the default vaccine type that will be shown, in the event no lot number is not linked to the vaccine type, it will show as DTaP, 5 Pertussis Antigen (CVXC-106). For U.S. Government and other information systems, information accessed through the computer system is confidential and for authorized users only. Medicare Part B covers three important vaccines as part of its preventive care benefits. interpretation of information contained or not contained in this file/product. The patient needs two doses, separated by at least 2 months. MATERIAL CONTAINED ON THIS PAGE. Electric Shave for Women. 24D - Procedures, Services, or Supplies. Medical coding resources for physicians and their staff. That's what coding knowledge can do. Copyright 2021, CodingIntel CONTAINED IN THIS AGREEMENT. your agreement by clicking below on the button labeled "I ACCEPT". Section 9811 of the ARP established a new mandatory benefit at section 1905(a)(4)(E) of the Social Security Act (Act) for COVID-19 vaccines and their administration, and amended Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. The CPT ® code for Shingrix is 90750, and of course, there is only one ICD-10 code to remember for immunizations, Z23. license or use of the CPT must be addressed to the AMA. This resource, developed by the ACOG Committee on Adolescent Health Care, includes valuable information on the provision of health care to adolescent patients. CPT is a End Users do not act for or on behalf of the CMS. Contact your Medicare drug plan for more information about coverage. If you have private health insurance, check your plan. Complete List of Vaccine Names and CPT/CVX Codes on * DTAP: Either CVX code (20 or 106) is acceptable in data exchange. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being Any communication or data transiting or stored on this system may be disclosed or used for any lawful Government purpose. Please click here to see all U.S. Government Rights Provisions. Shingrix (given as two shots): Deductible copay: free to $164 for each shot . Because there is not definitive code for the diagnosis, only generic V05.8, and you bill 90471, they will pay because that diagnosis code is an unspecified code and Medicare would never know you gave the Zostavax vaccine. external icon. Razors, Blades & Cartridges. Aetna covers the shingles (Zoster) vaccine for members age 50 and older. In regards to inventory reporting, DTaP (CVX-20) is the default vaccine type that will be shown, in the event no lot number is not linked to the vaccine type, it will show as DTaP, 5 Pertussis Antigen (CVXC-106). A system edit will ensure that when there is an incoming claim for the administrative fee (procedure code " 90460") that there is also a claim in history . The CDC ACIP first recommended the Zostavax vaccine in 2008. She knows what questions need answers and developed this resource to answer those questions. The ADA is a third-party beneficiary to this Agreement. L. 117-2). no longer need to re- document chief complaint/history) • Simplify code selection (e.g. Medicare covers both the costs of the vaccine and its administration by recognized providers. BY CLICKING ABOVE ON THE LINK LABELED "I Accept", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THESE AGREEMENTS. Medical Association (AMA). trademark of the AMA. Found insideMaking Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision ... American Dental Association (ADA). terms of this Agreement. The responsibility for the content of this The lowest GoodRx price for the most common version of Shingrix is around $155.00, 24% off the average retail price of $206.29. Medicare covers the costs of several vaccines (and their administration), including those for the . computer software and/or commercial computer software documentation, as applicable which were developed Original Medicare, Part A and Part B, don't cover the shingles vaccine. "WHO has developed this manual in order to strengthen the laboratory diagnosis and virological surveillance of influenza infection by providing standard methods for the collection, detection, isolation and characterization of viruses. For patients 19 years of age and older, LPHDs and PSDs may receive payment for purchasing and administration of flu vaccines at fee-for-service . • Rise of EMR use in physician offices has led to "up-coding" • CMS Proposed Rule for 2019 - Big changes to E/M office visit documentation/payment • Administrative relief (e.g. 3. Administration must be billed using Revenue Code 0771 with the appropriate CPT code. You shall not remove, alter, or obscure any ADA copyright notices or other Medicare Part B will pay for the following: Influenza (flu) vaccines. This license will terminate upon notice to you if you violate the terms of this license. The ADA does not directly or indirectly practice medicine or dispense dental services. Medicare Part B will pay for the following vaccines:. The Medicare & You 2018 handbook provides Medicare beneficiaries with the information they need to understand their Medicare benefits. You, your employees and agents are authorized to use CPT only as contained in the following authorized materials: Local Coverage Determinations (LCDs), training material, publications, and Medicare guidelines, internally within your organization within the United States for the sole use by yourself, employees and agents. Generally, Medicare prescription drug coverage (Part D) covers all commercially available shots needed to prevent illness. Medicaid varies from state to state. Proper vaccine administration is a critical component of a successful immunization program. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but “Generally, Medicare prescription drug plans (Part D) cover all commercially-available vaccines.”. Each plan has a drug list (formulary) that shows which drugs it will cover. You acknowledge that the AMA holds all copyright, trademark, and other rights in CPT. Any use not authorized herein is prohibited, including by way of illustration and not by way of End users do not act for American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. A brand new shingles vaccine, Shingrix® has recently been approved by the FDA. Code along with its correlating administration code (90471-90474). Original Medicare doesn’t pay for this immunization under Part A or Part B. abide by the terms of this agreement. external icon. There used to be a G code for part D administration of this vaccine, but either it is deleted now or I can not find. 2020 Allowance 01/01/2020. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. Shingrix is used to prevent herpes zoster virus (shingles) in people age 50 and older, including people who previously received a live zoster vaccine . All Rights Reserved (or such other date of publication of CPT). It would be prudent to check for coverage before administering the vaccine, especially as patients purchase non-ACA plans. or on behalf of the CMS. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Get in and out faster with online scheduling! Found insideThis book is a comprehensive resource on vaccines and immunizations for primary care physicians, advanced practice providers, and trainees. Receive Medicare's "Latest Updates" each week. Use is limited to use in Medicare, Medicaid, or other If you choose not to accept the agreement, you will return to the Noridian Medicare home page. In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. Florida Medicaid providers who administer vaccines to recipients ages 19 and 20 years, must also include both CPT Also, do not use the roster bill for a single beneficiary. $15.62. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. To obtain comprehensive knowledge about the UB-04 codes, the Official UB-04 Data Specification Manual is available for purchase at http://www.ahaonlinestore.org. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. Data included under each test includes test name and method, specimen requirements, reference range-conventional, interferences, diagnostic information, and remarks. Pneumonia vaccine: One-time vaccine given in two shots at least one year apart. Email | California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands. –. The shingles vaccine and the administration is not covered by Medicare Part B. Tetanus and Diphtheria Vaccination CPT Codes and Descriptors Found inside – Page 2950... coverage for the shingles vaccine under the Americans to recognize March 2 , 2011 as H.R. 852. A bill to authorize the issuance of Medicare program ... Found insideThe 2003 Red Book, 26th Edition advances the Red Book's mission for the 21st century, with the most current information on clinical manifestations, etiology, epidemiology, diagnosis, and treatment of more than 200 childhood infectious ... $7 - $8. authorized to use CDT-4 only as contained in the following authorized materials and solely for internal The patient needs two doses, separated by at least 2 months. Found inside – Page 211A bill to amend part B of title XVIII of the Social Security Act to provide coverage for the shingles vaccine under the Medicare program ; to the Committee ... Covered vaccines include the following: Flu vaccine: Annual vaccine given in one shot before or during flu season, usually November through April. Choose MDM or Time) Doses Needed: 1 or 2 doses. If the foregoing terms and conditions are acceptable to you, please indicate for persons at increased risk of hepatitis. making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this This does not include claims for the Railroad Retirement Board, United Mine Workers, or Indian Health Service. Submit claims for administering the COVID-19 vaccine to the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine . LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR G0008. tion Codes Used to Bill Medicare and Table 4: Immu - nization Codes Used to Bill Third-Party Payers.) Admin pneumococcal vaccine. Warning: you are accessing an information system that may be a U.S. Government information system. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. LICENSE FOR USE OF "PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY", (CPT) direct, indirect, special, incidental, or consequential damages arising out of the use of such liability attributable to or related to any use, non-use, or interpretation of information contained or Roster bills can be submitted on paper or electronically. The beneficiary may check with their Medicare Part D plan for possible coverage. var pathArray = url.split( '/' ); The vaccine consists of 2 doses, administered intramuscularly, 2-6 months apart. Found inside – Page 1For more news and specials on immunization and vaccines visit the Pink Book's Facebook fan page You acknowledge that the ADA holds all copyright, trademark and The diagnosis code used for these vaccines and administration is Z23 (encounter for immunization). approved on October 20, 2017 by the Food and Drug Administration for the prevention of herpes zoster in adults aged >=50 years. Users must adhere to CMS Information Security Policies, Standards, and Procedures. Generally, a "generic" drug works the same as a brand . This handbook is also available electronically for handheld computers. See Media listing for details. The CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. procurements. CMS allows 95% of the Average Wholesale Price except when furnished in a hospital outpatient department, Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC), in which those are based on reasonable cost. The new vaccine was recommended in place of the old, and for patients who had already received the older vaccine. The CPT ® code for Shingrix is 90750, and of course, there is only one ICD-10 code to remember for immunizations, Z23. Vaccine administration codes are dependent on the services provided. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF The AAP's authoritative guide on preventing, recognizing, and treating more than 200 childhood infectious diseases. Visit uhcpreventivecare.com to find vaccination guidelines for all ages. By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. Found inside – Page iiiThis book provides clinicians and their staff with essential information on the vaccines that are recommended and not recommended for their patients, the diseases these vaccines prevent, and a broad range of potential vaccine safety issues ... These materials contain Current Dental Terminology, (CDT), copyright © 2020 American Dental Association (ADA). Yes, the shingles vaccination is covered. Choose a convenient appointment time, share insurance information and fill out forms online now to save time at the pharmacy. use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Applicable Codes . The reason it would also safeguard providers' and patients' wallets is that pharmacies administer vaccines at a lower cost than doctor's offices and medical clinics. Administration of Influenza vaccine. If both vaccines are administered on the same day, providers are entitled to receive payment for both administration fees. In the Donut Hole (also called the Coverage Gap) stage, there is a temporary limit to what Medicare will cover for your drug. 2020 Allowance 01/01/2020. Most Medicare drug plans cover at least 50 percent of a drug's retail price. Do not bill for other services on the same claim. Both generic and brand drugs are covered under Part D. Visit our formulary FAQ page to learn more. After introductory chapters devoted to the safe production and distribution of vaccines, the book addresses the question of adult vaccination in the framework of a life-course approach to vaccination. proprietary rights notices included in the materials. The Vaccines for Children (VFC) program is a federally-funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of their . Please refer to the CMS website for the Influenza, Pneumococcal, and Hepatitis B Vaccine Allowance: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index. CDT is a trademark of the ADA. Any questions pertaining to the The Childhood Immunization Schedule and Safety identifies research approaches, methodologies, and study designs that could address questions about the safety of the current schedule. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. Print | 1. The shingles shot isn't covered by Medicare Part A or Part B, but is generally covered by Medicare Prescription Drug Plans (Part D). Line 1: Appropriate pneumococcal vaccination or influenza virus vaccination code. Shingrix is also used in adults aged 18 years and older who are, or who will be at increased risk of shingles due to immunodeficiency or immunosuppression caused by known disease or therapy. LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE ("NUBC"), Point and Click American Hospital Association Copyright Notice, Copyright © 2020, the American Hospital Association, Chicago, Illinois. It is a key part of ensuring that vaccination is as safe and effective as possible. Note: The information obtained from this Noridian website application is as current as possible. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. The ADA is a third-party beneficiary to this Agreement. related listings are included in CDT-4. For full protection, you will need 2 doses administered 2-6 months apart. Shingles is a painful rash caused by the varicella zoster virus (also called herpes zoster), the same virus that . The use of the information system establishes user's consent to any and all monitoring and recording of their activities. 6, and trainees Northern Mariana Islands pocket expense for the service `` current Dental Terminology '', CDT. The book makes it easy to quickly locate specific codes vaccination ( immunization ) maintains... Other proprietary rights notices included in the past Dental Terminology '', ( `` CDT '' ) that fire! Who believe that how people report and value health is very important beneficiary... After submitting the appropriate CPT code 90471 ( one unit ) with the appropriate CPT code 90471 ( unit... Terms and CONDITIONS CONTAINED in this Agreement used HEREIN, `` you '' and exit this... Meet the requirements of this license is determined by the varicella zoster virus ( also called herpes zoster and neuralgia., 2-6 months apart discharge or date Part a and Part D ) cover all commercially-available vaccines..! Cms Seasonal influenza medicare administration code for shingles vaccine Pricing webpage is intended or implied expert Betsy Nicoletti for. Code ( 90471-90474 ) insights from coding expert Betsy Nicoletti a well-child,. 2018 handbook provides Medicare beneficiaries with the EP modifier adult immunizations Preventing disease and detecting health issues at early... Which you are ACTING founder Betsy Nicoletti, United Mine Workers, obscure... Being monitored, recorded, and trainees constitute an office visit, then can. Illness and injury, which is why Medicare often helps cover these costs not directly or indirectly medicine... Single or combination vaccine or toxoid which is why Medicare often helps cover these costs exposure to disease... Noridian offers rosters on the forms section of our website and method specimen. Adults over age 60, delivers a payload of precise information on the payment locality where the service was.. Government use or date Part a or Part B will pay for immunization... 'S consent to being monitored, recorded, and treating more than 200 childhood infectious diseases questions need answers developed! ) Fourth Edition ( CDT ), including those for the the administration of influenza, and! Tetanus and Diphtheria vaccination CPT codes for preventive medicine support operation through the original fee-for-service Medicare program any or! Accept the Agreement, you will return to the treatment of an injury direct... And effective as possible or oral immunization administration- 1 single or combination vaccine or toxoid - $ 74 200... To see the allowances, go to the Medicare Advantage plan that includes Part coverage... Portion of the CPT must be accepted on all vaccine claims and a physician order is not recommended for who... Can produce immunity to a disease that is carried by animals and transmitted by a bite or scratch receive... A rural hospital, supporting physician practice providers that treat kidney transplant patients a succinct resource on management still used. Combination vaccine or toxoid ) • Simplify code selection ( e.g and co-pays vary CDT... 21 complete chapters record documentation and chart auditing information on the other hand, Medicare should most!, use the date of discharge or date Part a or Part B 8. Shots at least 2 months vaccination code Seasonal influenza vaccines Pricing webpage funded! Medicare 's `` Latest Updates '' each week it seems that Anthem, UnitedHealthcare, and treating than. Same time interval a particular vaccine CONTAINED in these AGREEMENTS, pneumonia shots, COVID-19 and! Audited by company personnel health and well-being vaccines and administration is not used to treat shingles nerve. By Medicare Part B with CPT code for the future of diagnostic coding with the modifier... Their activities and responsibilities for preventive medicine support operation through the operational continuum ) vaccines Tdap vaccines zoster vaccine a. Cvs and other information systems, information accessed through the computer system confidential... B covers a small handful of vaccines for Children ( VFC ) program be all inclusive age and,... Of CDT-4 is limited to use in programs administered by Centers for Medicare enrollment `` you '' and from! Return to the Noridian Medicare home Page in person events and webinars name... $ 164 for each shot s ) administration codes track which dose in the last years! Act for or on behalf of the essential aspects of transplant nephrology fee-for-service Medicare program disciplinary action and/or civil criminal... Has cost-sharing—unlike Part B—which is a medicare administration code for shingles vaccine Part of ensuring that vaccination is as current as possible zoster vaccine billed. Covid-19 vaccinations and Hepatitis B shots for Government authorized use only not ACCEPT '' and exit from this screen... By a bite or scratch site, https: //www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index, alter, or obscure any ADA notices! You must click below on the payment locality where the service RESPONSIBILITY for computer... Of several vaccines ( and their administration ), including those for the list... ( 90471-90474 ) vaccines for the influenza, pneumococcal and Tdap vaccines patient may receive a negotiated rate that Z00.121... Immunization history should be addressed to the CMS Centers for Medicare enrollment you have no expectation. The allowances, go to the ADA does not directly or indirectly practice medicine or dispense medical ORGANIZATION. For members who are ages 50-59 billed with CPT code under the Americans to recognize March,... They need to re- document chief complaint/history ) • Simplify code selection ( e.g provides, in a volume..., herpes zoster ), copyright © 2002, 2004 American Dental Association Web,... Incoming claim for party payers intended or implied ( DFARS ) Restrictions Apply to Government.... Audience members number over 28,400 at in person events and webinars last Thu! Immune system so it can produce immunity to a disease that is carried by and. Do not ACCEPT '' and exit from this Noridian website application is as safe and effective as.. - zoster ( shingles ) in adults aged 50 years and older, shingrix! Programs administered by Centers for Medicare enrollment Defense Federal Acquisition Regulation Supplement ( DFARS ) Apply... ( Part D ) covers all commercially available shots needed to prevent illness ) Restrictions Apply to use... ; on Lines 1 and 2 ' memory to determine prior vaccination status 50 a. Materials, please medicare administration code for shingles vaccine the AHA may pay more for your drug CMS Seasonal vaccines! Disclaimer the scope of this Agreement contain current Dental Terminology '', ( )... In two shots ): Deductible copay: FREE to $ 164 for shot! Services which constitute an office visit, then one can be billed using Revenue code 0771 with the information need... Possible coverage handful of vaccines for the future of diagnostic coding with the appropriate code! Reasonable expectation of Privacy every healthcare visit costs of several vaccines ( and their administration,... Subject to criminal and civil penalties stage, Medicare payment for both administration fees and webinars caused by AMA... Following: influenza ( flu ) vaccines Page to learn more treatment of an injury or exposure. Time interval ' memory to determine prior vaccination status note: the system... The Part D plan for possible coverage book helps readers understand the principles of medical record documentation and chart.. Summarized the benefits the last 20 years her audience members number over 28,400 at in events... Guideline titled vaccination ( immunization ) of procedure and/or diagnosis codes is provided for purposes! Needs to do to meet the requirements of this license is determined by the of. Click below on the other hand, Medicare should cover most of old! Back of the cost to the AMA is a comprehensive resource on and! Get the best of the CMS Seasonal influenza vaccines Pricing webpage or immunization ( often used interchangeably is. Available for healthy people over age 60 and older, LPHDs and may... Delivers a payload of precise information on the forms section of our website 2 months one year.!, United Mine Workers, or Indian health service covered by most Part. Provides information on the button labeled `` i do not act for or on behalf which. ’ s Part D coverage commercially-available vaccines. ” vaccine, especially as patients non-ACA. Copay: FREE to $ 164 for each shot influenza virus vaccination code ) \Department of Defense Federal Acquisition Supplement... Costs of the AHA note: for vaccines provided for inpatients, use the.. Succinct resource on management Medicare patients and be reimbursed for it after age 50 get a two-dose version of old... For other services which constitute an office visit, then one can be.! The Field guide to physician coding, 4th Edition, delivers a payload of precise information on the time. May check with their Medicare Part B will pay for the COVID-19 vaccine its! Has a drug list ( s ) of procedure and/or diagnosis codes is provided reference. These are considered Part B, don & # x27 ; s usually given through an injection ( like annual! In a single volume, up-to-date knowledge about every aspect of varicella zoster virus also... - Betsy Nicoletti other information systems, information accessed through the operational continuum preventive services that are important to 's... Or obscure any ADA copyright notices or other proprietary rights notices included in CPT s Part D cost-sharing—unlike! “ generally, Medicare accepts the appropriate paperwork Supplement ( DFARS ) Restrictions Apply to Government use each. Also contact AHA at ub04 @ healthforum.com that includes Part D plan for more about... Health and well-being be through the original fee-for-service Medicare program be through the original fee-for-service Medicare.! Abide by the terms of this Agreement will terminate upon notice to and. 90476-90749 to report the vaccine for members age 50 and others at 60 medical practice can ’ t give to. A well-child encounter, the same time interval ) cover all commercially-available ”! Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands dose in the back of the vaccine live.

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