Stop Billing Vaccines Through PBMs
Billing the medical benefit captures significantly more per claim than PBM. DocStation automates the entire process—from eligibility to ERA tracking.
- BIN Billing auto-translates D.0 to 837P medical claims
- Real-time eligibility checks before you bill
- Vaccine-specific claim templates with dynamic product types
- ERA tracking and payment reconciliation
$18–$172
More Per Claim
20,000+
Claims Analyzed
3,000+
Payers
See Vaccine Billing in Action
Revenue You're Missing
See the difference between medical benefit billing and PBM reimbursement on common vaccines.
| Vaccine | CPT | Claims | Medical | PBM | Diff | Total Captured |
|---|---|---|---|---|---|---|
| Capvaxive | 90684 | 394 | $348.86 | $182.96 | +$165.90 | $65,365 |
| Spikevax (12+yrs) | 91322 | 4,149 | $195.34 | $85.66 | +$109.68 | $455,043 |
| Spikevax (6mo-11yrs) | 91321 | 140 | $174.54 | $74.80 | +$99.74 | $13,964 |
| Afluria, Fluzone | 90658 | 594 | $90.99 | $30.43 | +$60.56 | $35,973 |
| Prevnar | 90677 | 581 | $339.96 | $294.88 | +$45.08 | $26,194 |
| Afluria, Fluarix, Flulaval, Fluzone | 90656 | 1,059 | $63.46 | $37.71 | +$25.75 | $27,269 |
| Boostrix, Adacel | 90715 | 125 | $69.06 | $47.56 | +$21.50 | $2,688 |
| Comirnaty | 91320 | 2,190 | $194.96 | $174.00 | +$20.96 | $45,896 |
| Fluad | 90653 | 8,018 | $123.67 | $105.17 | +$18.50 | $148,295 |
| Flucelvax | 90661 | 3,067 | $71.47 | $58.61 | +$12.86 | $39,451 |
Analysis of 20,000+ medical benefit claims compared against 100,000+ PBM claims from integrated pharmacy systems. Results may vary based on payer mix and geographic region.
How It Works
Administer the Vaccine
Process the vaccine through your dispensing system as you normally would.BIN Billing Translates
Your D.0 claim is automatically translated into an 837P medical claim.Eligibility & Submit
Real-time eligibility checks confirm coverage, then the claim is submitted to the medical payer.Get Paid More
Track ERAs and remittances. Watch your per-vaccine revenue increase.
Built for Pharmacy Vaccine Programs
BIN Billing
Automatically translate D.0 pharmacy claims into 837P medical claims. Works with all plans.
Claim Templates
Pre-built templates for common vaccines with dynamic product types—no manual coding.
Real-Time Eligibility
Verify coverage before you bill—Medicare, Medicaid, Medicare Advantage, and commercial. 3,000+ payers supported.
ERA Tracking
Monitor remittances, manage denials, and track revenue—all in one dashboard.
Ready to Earn More Per Vaccine?
Join pharmacies across the country capturing more revenue by billing the medical benefit.