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MARYLAND VFC PROGRAM VACCINE INVENTORY FORM Fax Pages 1 & 2 To: (410) 333-5893 VFC PIN #: (REQUIRED) Today s Date: (REQUIRED) / Name of Physician s Office, Practice, Clinic, Etc.: (REQUIRED) Phone:.

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The following is a list of diseases that these vaccines prevent: Diphtheria. Haemophilus influenzae type b (Hib) Hepatitis A. Hepatitis B. Human Papillomavirus (HPV) Influenza (flu) Measles. Meningococcal disease.

Note: Healthcare providers cannot refuse to vaccinate your child if you are unable to pay the vaccine administration fee. Other fees the VFC Program provider may charge include: Fees for non-vaccine services that occur during the office visit, like an eye exam or blood test. An office fee for the visit.

To bill Medi-Cal for the VFC dose administration fee, VFC providers shall report the vaccine/toxoid product code(s) with a modifier code of “SL”, which identifies the service as a “state-supplied vaccine”.

The display monitor needs to be visible from the outside of the vaccine refrigerator/freezer storage unit. The data logger must also be able to produce downloadable data of temperature records in 15-minute intervals. The accuracy of the data logger must be within +/- 1-degree Fahrenheit. A buffered temperature probe.

A child is eligible for the VFC Program if they are younger than 19 years of age and are one of the following: Uninsured. Medicaid-eligible or Medicaid-enrolled. American Indian or Alaska Native. Underinsured.

The Vaccines for Children (VFC) program is a federal entitlement program created in 1994 to supply private and public health-care providers with federally purchased vaccines at no cost for administration to eligible children and adolescents in ance with the Recommended Childhood and Adolescent Immunization ...

The Vaccines For Children (VFC) Program supplies vaccines at no cost to providers who serve eligible children from birth through 18 years of age.

The Vaccines for Children (VFC) Program provides vaccines to children whose parents or guardians may not be able to afford them.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232