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A serum B12 blood test is the only reliable method

Most clearinghouses and insurance carriers expect the codes to come to them in an 11-digit format which look like: 5-4-2

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It applies to each additional vaccine/toxoid component only after the first one has already been billed using the right administration code (like CPT 90471) This code is most commonly used in pediatric clinics where multiple shots are given on every visit