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Nutritional Deficiency: Deficient levels of a few nutrients-the B1 also known as thiamine B6 also known as pyridoxine B12 cobalamin and E-can affect peripheral nerve function Exposure to Toxins: Longterm exposure to noxious agents-heavy metals such as lead and mercury industrial chemicals as well as chemotherapeutic drugs can damage nerves

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This means that the duration of the provision of dental services that are inextricably linked to dialysis services for these beneficiaries with ESRD may be ongoing but still would have to be medically reasonable and necessary

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As the shortage that justified wide compounding eased, the enforcement focus shifted to the claims clinics use to sell it