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Commonly Reported (Intranasal): Mild stinging or irritation in nasal passages (transient, resolves within minutes) Nasal dryness with repeated daily use Mild taste or odor disturbance immediately after administration Uncommonly Reported: Headache (mild, typically with higher doses) Dizziness (transient) Fatigue (paradoxical, reported rarely) Notably Absent: Sedation or drowsiness (consistently absent across clinical comparisons) Cognitive impairment or psychomotor slowing Tolerance development within standard 14-day courses Physical dependence or withdrawal symptoms upon cessation Rebound anxiety after treatment discontinuation Muscle relaxation or ataxia Serious Adverse Events: No serious adverse events have been attributed to Selank in published clinical literature

Holding ASC utilization, the ASC conversion factor, and the mix of services constant from CY 2024, we proposed to compare the estimated total payment using the CY 2025 ASC relative payment weights with the estimated total payment using the CY 2026 ASC relative payment weights to ( take into account the changes in the OPPS relative payment weights between CY 2025 and CY 2026

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