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In response to the comment that stated that the Complex Organization Adjustment does not account for unique circumstances faced by ACOs that serve a high proportion of beneficiaries, we note that, while the methodology for the health equity adjustment and the Complex Organization Adjustment differ, both adjustments aim to upwardly adjust an ACO's quality score for purposes of determining whether an ACO met quality performance standard

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B12 IM injections are often recommended for individuals with conditions that affect B12 absorption, such as pernicious anemia, atrophic gastritis, or those who have undergone certain gastrointestinal surgeries