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In the CY 2004 OPPS final rule with comment period (68 FR 63459), we adopted a new methodology to calculate unadjusted copayment amounts in situations including reorganizing APCs, and we finalized the following rules to determine copayment amounts in CY 2004 and subsequent years

Licensed B12 medicines (including hydroxocobalamin injections and some cyanocobalamin tablets) are regulated by the MHRA and have specific approved indications and dosing

It is not a drug, food, dietary supplement, or cosmetic, and has not been approved by any regulatory authority

Notably, it can potentially affect the efficacy or side-effect profile of drugs such as nitroglycerin, nitrates, and some chemotherapy agents

De Geer, 2018)