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Symptoms of vitamin B-12 deficiency include: Fatigue Difficulty concentrating Decreased mood Loss of appetite Poor memory Constipation Higher-risk groups for vitamin B-12 deficiency include people with intestinal disorders such as Crohns or Celiac disease, as well as those who suffer from muscular degeneration, Lou Gehrigs disease or diabetes

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If a protocol calls for 2mg and you accidentally calculate for 2mcg, you are dosing at one thousandth of the intended amount

Comment: One commenter requested CMS reconsider in future rulemaking requiring hospitals to encode a maximum allowed amount that would reflect the maximum total allowed amount a hospital has historically received for a third party payer for an item and service

Most nasal spray protocols settle on 500mcg administered 2-3 times daily, totaling 1000-1500mcg per day

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