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This data supports our findings that nave mice supplemented with cyanocobalamin consistently showed decreased alpha diversity due to the reduced abundance of Firmicutes species and an increase in Parasutterella species

The study encompassed information from 21 clinics across four U.S

Response: We note that our authority for an adjustment under section 1833(t)(13)(B) of the Act only applies to rural hospitals, so we would not have authority to extend this adjustment to a hospital classified as urban