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Required documentation includes the full drug name, the National Drug Code (NDC) number, dose and units dispensed, route of administration, an ICD-10-CM diagnosis code establishing medical necessity, and evidence that no specific HCPCS code exists for the drug

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(A third dose for severely immunocompromised people who got the Pfizer vaccine is also allowed.) This question is important because the third dose previously authorized is a full dose of the Moderna vaccine, the 100-microgram shot, one month after someones second dose

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