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After that, a once per month dose is needed to maintain proper B12 levels

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We proposed to apply this modified approach for agreement periods beginning January 1, 2027, instead of January 1, 2026, because the application cycle for agreement periods starting January 1, 2026, was already underway when the CY 2026 PFS proposed rule appeared in the Federal Register , and this proposal would not be finalized until November 2025, by which point we will be preparing to grant or deny applications for agreement periods starting January 1, 2026, in early December