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An initial alternative proposal was published in CY 22 Home Health PPS final rule (86 FR 35874) but was not finalized due to public comments and requests that CMS establish a Technical Expert Panel (TEP) to inform the development of the SFP

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Neurologic symptoms may take longer, but many people notice energy/mood improvements within days to weeks once deficiency is corrected

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The compound is effective precisely because it produces significant physiological changes, and those changes come with a well-documented side effect profile that every potential user should understand thoroughly before starting