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Initial Billing Error: The practice billed both the injection administration (95115) and a level 2 office visit (99212)

Deficiency may occur from conditions like pernicious anemia, gastrointestinal disorders, or surgeries that affect nutrient absorption

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During later infancy and early childhood inadequate intakes of B12 due to low intake of animal-source foods and possibly malabsorption, may play a role (Sobczynska-Malefora et al., 2023)

Non-specific symptoms and signs are loss of appetite, diarrhoea, fatigue and weakness, shortness of breath, low blood pressure, confusion, and change in mental states.9 29 Classical manifestations include Hunters glossitis, megaloblastic anaemia, and subacute combined degeneration of spinal cord (Table 29)