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Proposed Changes to Surgical Hierarchies Some inpatient stays entail multiple surgical procedures, each one of which, occurring by itself, could result in assignment of the case to a different MS-DRG within the MDC to which the principal diagnosis is assigned

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Cyanocobalamin has to go through a complex conversion process within the body in order to become active and many people cannot do these conversions well, so often much of the dose goes unused (even with a shot)