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Current guidelines for B12 replacement Vitamin B12 is available in four different formulationscyanocobalamin (CN-Cbl), hydroxocobalamin (OH-Cbl), methylcobalamin (methyl-Cbl), and adenosylcobalamin (adenosyl-Cbl)depending on the R residual group attached to the core cobalamin molecule

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Additionally, while unspent funds received for a performance year must be reallocated in the spend plan for the ACO's next performance year as noted at 425.640(e)(3), if an ACO fails to spend a majority of the prepaid shared savings received in a performance year, we may withhold future quarterly payments until the ACO spends the funding already received and reports this spending to CMS through an updated spend plan