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(2) Data Source for Calculating the Allowed Amounts In the CY 2024 OPPS/ASC final rule with comment period (88 FR 82101), we stated our belief at the time that hospitals should retain flexibility, in the interest of reducing burden, to determine the best data source(s) for calculating the estimated allowed amount data element, though we agreed with commenters that using information from EDI 835 ERA transaction data would appear to meet our requirements
Not marketing claims, but documented effects from clinical studies and established mechanisms of action
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