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Handling B12 Vials Safely The vitamin B12 vial itself needs a little prep work, too

Signs of this may include the following symptoms: tingling, feeling cold in the hands and feet, weakness and rapid fatigue, and difficulty concentrating

An intramuscular injection bypasses the gut entirely

In the liver it is metabolized to N-methylnicotinamide, methylpyridonecarboxamides, glucuronide and complex with glycine, excreted by the kidneys

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If the influenza vaccination is provided in response to a potential exposure (e.g., Td vaccine administered as part of wound care), the ICD-10 code describing the underlying condition should be reported as the primary diagnosis, with Z23 (Encounter for immunization) used as the secondary diagnosis code