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Bilateral injections are billed with a -50 modifier per payer guidelines

The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool was used to assess the certainty of the evidence for the two primary biochemical outcomesserum vitamin B12 concentration increase and homocysteine reductionacross all included studies, and separately for randomised controlled trials (RCTs) and observational studies

Compounded medications are not the same as commercially available FDA-approved branded medications

But when it comes to weight changes, its a bit different

Some patients may experience nausea, headache, or a feeling of sleepiness after the injection