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Hydroxocobalamin may also be given intravenously in certain scenarios (for example, 5 g IV for acute cyanide poisoning antidote therapy), but such high-dose use is in emergency settings and distinct from routine deficiency treatment

(10) modification of the validation targeting criteria to include any hospital with a two-tailed confidence interval that is less than 75 percent and which submitted less than four quarters of data due to receiving an extraordinary circumstances exception (ECE) for one or more quarters beginning with the FY 2027 payment determination