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of this proposed rule), we believe accounting for the impact of improper payments on performance year expenditures and factors used to calculate updated historical benchmarks would not result in an increase in spending beyond the expenditures that would otherwise occur under the statutory payment methodology in section 1899(d) of the Act

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It is known to induce CYP3A4 and CYP2C8/9 enzymes, starting within 4 days of the first dose and returning to baseline 14 days after discontinuation

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