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Understanding first-pass metabolism is not merely a pharmacokinetic concept—it directly influences: ✔ Drug selection ✔ Dose optimization ✔ Route of administration ✔ Drug–drug interactions ✔ Pharmacogenomic variability ✔ Therapeutic efficacy and patient safety Ultimately, successful pharmacotherapy depends not only on what drug we prescribe, but also on how much of that drug actually reaches its therapeutic target

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CPT code 90471 applies whenever a provider administers one or more injectable vaccines and counseling-based pediatric coding does not apply