Provider Registration and Profile Forms
I agree that vaccine supplied by the New York State Immunization Program will be administered only to a child < 19 years of age who:(1) is enrolled in Medicaid/Medicaid Managed Care (2) has no insurance (3) is an American Indian or Alaskan Native (4) is underinsured (health insurance does not pay for vaccines), or (5) is enrolled in Child ... ................
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