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183 It is therefore important to recognise the potential likelihood of neuropathy induced by vitamin B 12, occurring or being exacerbated as a result of the co-prescription of medications commonly used to treat these co-morbidities, particularly since they are typically long-term drug treatments

Response: We interpret both comments as suggesting that CMS perform two versions of Shared Savings Program calculationsone that makes adjustments for SAHS billing activity and one that does notand then issuing initial determinations based on the version of the calculations that would result in an ACO maximizing their shared savings or minimizing their shared losses for the performance year