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These agents should not be used alone secondary to increases in plasma renin activity, cardiac output, and heart rate and should therefore be used only when -blockers and diuretics are part of the antihypertensive regimen

As an extreme example for purposes of illustration, in contract negotiations hospitals would not generally negotiate payments of $1,500 for heart transplant cases and MA organizations would not generally negotiate payments of $150,000 for simple pneumonia cases because those rates would not reflect the relative resources required to provide those services

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