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We note that, in accordance with section 16002 of the 21st Century Cures Act, we apply a budget neutrality factor calculated as if the cancer hospital adjustment target payment-to-cost ratio was 0.88, not the 0.87 target payment-to-cost ratio we discuss in section II.F

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Comprehensive blood work test panels include not only serum B12 blood test results but also homocysteine levels , folate deficiencies assessment, and evaluation of related nutrients including Vitamin D3 and essential minerals

For progressive forms, such as secondary progressive MS (SPMS) and primary progressive MS (PPMS), therapeutic options are limited compared to relapsingremitting MS (RRMS) [141]