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That is, we use the unweighted average of the wage indexes from all CBSAs (urban areas) that are contiguous (share a border with) to the rural counties to compute the rural floor (72 FR 47323

For any subsequent applicable periods that the generic Part D rebatable drug appears as currently in shortage, CMS will reduce the total rebate amount in accordance with the drug shortage reduction proposed at 428.301, starting with the highest reduction (that is, 75 percent for a generic Part D rebatable drug)

I guess this comes down to the growing use of social media and exposure to biohacking/optimal health gurus (i.e ben greenfield, thomas de lauer, huberman, ergogenic health etc)

L.CavalieriD