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The commenter stated that this burden is especially onerous for smaller and rural hospitals that have fewer staff and already face compliance challenges and limited resources and it is precisely those hospitals that often have less sophisticated contracting (or more capitated arrangements) and will struggle to compute medians from messy data

Numbness and tingling in hands, legs, and feet: These are signs of the crucial role Vitamin B12 plays in the proper functioning of the nervous system

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We provide summaries of the public comments, and our responses are set forth in the various sections of this final rule with comment period under the appropriate headings